THERESA M HAVALAD


Address: 870 Grand Ave, Saint Paul, MN 55105-3291
Phone: 6513265650

THERESA M HAVALAD (NPI# 1942649181) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1942649181
Entity Type Individual
Full Name THERESA M HAVALAD
Credential NP
Practice Address 870 Grand Ave
Saint Paul
MN 55105-3291
Mailing Address 1690 University Ave W Ste 370
Saint Paul
MN 55104-3723
Practice Telephone 6513265650
Practice Fax Number 6513265671
Mailing Telephone 6512325321
Enumeration Date 2013-06-20
Last Update Date 2018-03-17
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363L00000X Nurse Practitioner 5534 MN Physician Assistants & Advanced Practice Nursing Providers
N 363L00000X Nurse Practitioner 041-374413 IL Physician Assistants & Advanced Practice Nursing Providers

Provider Secondary Practice Location

Address Telephone Number Fax Number
610 S Maple Ave, Suite 4600, Oak Park, IL 603041091 7086602240 7086602243

Office Location

Street Address 870 GRAND AVE
City SAINT PAUL
State MN
Zip Code 55105-3291

Providers in the same location

NPI Name Taxonomy Address Enumeration
1295711265 Rolf Peter Ulland Obstetrics & Gynecology 870 Grand Ave, Saint Paul, MN 55105-3291 2005-12-21
1114432440 Fairview Pharmacy Services, LLC Non-Pharmacy Dispensing Site 870 Grand Ave, Saint Paul, MN 55105-3291 2017-12-08
1336671205 Christina Rose Werman Family Medicine 870 Grand Ave, Saint Paul, MN 55105-3291 2017-03-30
1275918658 Jenna Lynn Larson Viland Nurse Practitioner 870 Grand Ave, Saint Paul, MN 55105-3291 2015-07-27
1518005230 Laurie Radovsky Family Medicine 870 Grand Ave, Saint Paul, MN 55105-3291 2007-02-02
1487733408 Prairiestone Pharmacy LLC Pharmacist 870 Grand Ave, Saint Paul, MN 55105-3291 2006-11-02
1912084674 Shabbir S Dawoodbhai Pharmacist 870 Grand Ave, Saint Paul, MN 55105-3291 2006-11-01
1790872331 Daniel J Sullivan Family Medicine 870 Grand Ave, Saint Paul, MN 55105-3291 2006-10-06
1558473702 Bernadette Lee Clevenger Family Medicine 870 Grand Ave, Saint Paul, MN 55105-3291 2006-08-31
1356458723 Gervais Patrick Chokote Moche Family Medicine 870 Grand Ave, Saint Paul, MN 55105-3291 2006-08-23
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1437704020 Grand Avenue Smiles Dentist 1845 Grand Avenue, St. Paul, MN 55105 2019-08-09
1205304839 Michelle Marie Loken Price Acupuncturist 877 Lincoln Ave, Saint Paul, MN 55105 2018-11-13
1326566936 Becky Lynn Lawyer Counselor 1704 Palace Ave, St Paul, MN 55105 2017-09-04
1679020226 Internal Revolution Counseling and Consulting, L.L.C. Psychologist 1123 Grand Avenue, Suite 201, Saint Paul, MN 55105 2016-09-01
1487059689 Jennifer Mason Lactation Consultant, Non-RN 1382 Summit Ave, Saint Paul, MN 55105 2014-10-30
1679818850 Marc Lane Wolfson Registered Nurse 1148 Grand Avenue, St. Paul, MN 55105 2012-11-29
1457602781 Charting Your Success Social Worker 2050 St Clair Avenue, Suite 1e, St Paul, MN 55105 2012-09-26
1871867549 Stacia Hanson Ma Lp LLC Psychologist 889 Grand Avenue, Suite 203, St Paul, MN 55105 2012-02-28
1265718142 Caitlin Marie Young Midwife 968 Grand Ave., St. Paul, MN 55105 2011-10-24
1659512622 Wellness Cooperative LLC Chiropractor 976 Grand Ave., St. Paul, MN 55105 2009-03-20
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Taxonomy Information

Taxonomy Code 363L00000X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner

Taxonomy Definition

(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.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1063039378 Samantha Dion Richardson Nurse Practitioner 3225 Dogwood Dr, Saint Paul, VA 24283-2543 2020-07-02
1033547708 Jane Monita Nurse Practitioner 225 Smith Ave N Ste 200, Saint Paul, MN 55102-2697 2013-10-16
1851541239 Emily A. Wolfe Nurse Practitioner 640 Jackson St - Mc 11108b, Healthpartners Regions Specialty Clinics, Saint Paul, MN 55101-2502 2008-09-23
1629264668 Chris-ann Lauria Nurse Practitioner 1145 Homer St, Saint Paul, MN 55116-3231 2007-09-24
1871790956 Susan M Knier Nurse Practitioner 178 9th St E, Saint Paul, MN 55101 2007-07-02
1275625485 Michele Johnson Nurse Practitioner 916 Rice St, Saint Paul, MN 55117-5425 2006-09-28
1063517100 Samuel Yaw Boadu Nurse Practitioner 409 North Dunlap Street, Open Cities Health Center, Saint Paul, MN 55104-4201 2006-09-13
1205843307 Jean Marie Kummer Iv Nurse Practitioner 4831 Richard Ln, Saint Paul, MN 55122-2784 2006-08-02
1568489037 Anna Mergit Novak Nurse Practitioner 1055 Westgate Dr Ste 100, Saint Paul, MN 55114-1451 2006-07-17
1144287251 Diane M Budnick Nurse Practitioner 1700 University Ave W, Medical Advanced Pain Specialists, Saint Paul, MN 55104-3727 2006-05-01
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Competitor

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City SAINT PAUL
Zip Code 55105

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Dataset Information

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.

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