Connie Theisen

Practice location

Address

9479 Garland Ave, Maple Grove, MN 55311-5480

Phone

(763) 494-8787

Mailing address

12748 Walter Dr, Rogers, MN 55374-5822

Registered specialties

Registry record

NPI

1063599892

Entity type

Individual

Sex (as registered)

Female

NPI issued

1 Nov 2006

Record last updated

3 Sep 2008

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.