Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Michelle L Theobald, PA-C

Individual provider Family Medicine Physician · NPI 1912981341

Michelle L Theobald, PA-C is a Physician Assistant in Edina, Minnesota. Qualified in 2004, 22 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
22
Licensed in
MN
In the registry since
2005
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

6405 France Ave S # SW200
Edina, MN 55435-2163
Phone: (952) 915-5482
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 9833 (MN)

Record details

NPI number1912981341
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedNovember 30, 2005
Last updated in NPPESOctober 25, 2007

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2004 (22 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations8 on file with Medicare

Other providers in Edina