Provider Demographics
NPI:1356150072
Name:THEISEN, CARA
Entity type:Individual
Prefix:
First Name:CARA
Middle Name:
Last Name:THEISEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 GATEWAY HILLS PARK DR
Mailing Address - Street 2:
Mailing Address - City:AMES
Mailing Address - State:IA
Mailing Address - Zip Code:50014-7847
Mailing Address - Country:US
Mailing Address - Phone:715-226-2693
Mailing Address - Fax:
Practice Address - Street 1:1320 GATEWAY HILLS PARK DR
Practice Address - Street 2:
Practice Address - City:AMES
Practice Address - State:IA
Practice Address - Zip Code:50014-7847
Practice Address - Country:US
Practice Address - Phone:715-226-2693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-07
Last Update Date:2025-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health