Mallow, Teresa

Mallow, Teresa is an sole proprietor health care provider with primary practice located at 6500 Excelsior Blvd , St Louis Park MN 55426-4702. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Mallow, Teresa can be contacted via phone (952) 993-3123.

Contact Information

Primary practice address
6500 Excelsior Blvd St Louis Park MN 55426-4702
Phone: (952) 993-3123
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X A0810006 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X G0810008 Minnesota

Profile Details

NPI number 1396055851
LBN Legal business name Mallow, Teresa
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 19th, 2010
Last updated Oct 19th, 2010 - about 15 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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