DARLA R THEOBALD (NPI# 1043293657) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1043293657 |
| Entity Type | Individual |
| Full Name | DARLA R THEOBALD |
| Credential | NP |
| Practice Address |
1025 Marsh St Mankato MN 56001-4752 |
| Practice Telephone | 5076254031 |
| Mailing Telephone | 5076254031 |
| Enumeration Date | 2005-11-29 |
| Last Update Date | 2020-09-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363L00000X | Nurse Practitioner | 1113 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363L00000X | Nurse Practitioner | R1159484 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1015 Marsh St, Mankato, MN 560015294 | 5073894700 |
| Street Address |
1025 MARSH ST |
| City | MANKATO |
| State | MN |
| Zip Code | 56001-4752 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154316206 | James J Milavetz | Internal Medicine | 1025 Marsh St, Mankato, MN 56001-4752 | 2005-09-14 |
| 1811596059 | Kiman Dinh | Pharmacist | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-10-20 |
| 1295349710 | Joseph Flynn | Pharmacist | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-09-02 |
| 1972115962 | Mohamed A Ibrahim | Community Health Worker | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-08-20 |
| 1174147110 | Emily Behrend | Advanced Practice Midwife | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-06-05 |
| 1205455755 | Whitney Farr | Social Worker | 1025 Marsh St, Mankato, MN 56001-4752 | 2020-04-15 |
| 1134765233 | Kay S Williams | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-11-23 |
| 1871138263 | Sydney Mcinnis | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-11-09 |
| 1730739061 | Kelsey Elizabeth Mork | Physician Assistant | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-09-18 |
| 1891345369 | Matthew Joseph Perri | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-09-17 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154935435 | Kelly Nicole Ricke | Physical Medicine & Rehabilitation | 1 Civic Center Plaza, Hockey Office Complex, Mankato, MN 56001 | 2020-09-03 |
| 1649816786 | Ashley Lynn Walters | Technician, Other | 501 Madison Ave., Mankato, MN 56001 | 2019-11-25 |
| 1720631716 | Dovetail Traslation LLC | Interpreter | 212 Dublin Ct, Same As Above, Mankato, MN 56001 | 2019-07-19 |
| 1093377871 | Lindsey Keithahn | Counselor | 2100 Bassett Drive, Mankato, MN 56001 | 2019-07-02 |
| 1255803813 | Amy Marie Williams | Acupuncturist | 709 S. Front Street, Suite 5, Mankato, MN 56001 | 2018-12-20 |
| 1518437573 | Ashley Blanchard | Acupuncturist | Vida Salon Suites 1351 Madison Avenue, Suite F/ Suite 206, Mankato, MN 56001 | 2018-12-03 |
| 1831687235 | Christian Goetz | Specialist/Technologist | 401-477 South Rd, Mankato, MN 56001 | 2018-05-01 |
| 1366949141 | Minnesota State College and Universities | Specialist/Technologist | 135 Myers Field House, Mankato, MN 56001 | 2018-04-09 |
| 1780191775 | Kevin David Nelson | Pharmacist | 111 Redtail Ct Apt 308, Mankato, MN 56001 | 2017-12-29 |
| 1972014231 | Rylee Wagner | Speech-Language Pathologist | Mankato Clinic Pediatric Therapy Services, 150 St. Andrews Court, Suite 310, Mankato, MN 56001 | 2017-10-13 |
| Find all providers in zip 56001 | ||||
| Taxonomy Code | 363L00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners. |
| Notes: Source: (1) American Nurses’ Association, American Nurses Credentialing Center, 1996 Certification Catalogue. (2) ) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, The Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, Illinois: 1994, p. 549. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144217209 | Erin E Bissonnette | Nurse Practitioner | 1230 E. Main Street, Mankato Clinic @ Main Street, Mankato, MN 56002-8674 | 2005-10-04 |
| 1134765233 | Kay S Williams | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-11-23 |
| 1871138263 | Sydney Mcinnis | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-11-09 |
| 1891345369 | Matthew Joseph Perri | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-09-17 |
| 1013576594 | Omar G Ferrer | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001 | 2019-06-10 |
| 1225591357 | Amanda Logan | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-04-06 |
| 1023581790 | Laura Renee Fisher | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2019-01-06 |
| 1790266963 | Brittany Kosinski | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2018-08-27 |
| 1295213650 | Stacy Marie Blank | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2018-07-29 |
| 1619480092 | Justin Jaspers | Nurse Practitioner | 1025 Marsh St, Mankato, MN 56001-4752 | 2017-11-08 |
| Find all providers in MANKATO | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.