Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Teresa Mallow

Individual provider Adult Health Nurse Practitioner · NPI 1396055851

Teresa Mallow is a Nurse Practitioner in St Louis Park, Minnesota. Qualified in 2010, 16 years ago. Practices with Park Nicollet Clinic, a 1,773-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Minnesota.

Years since qualifying
16
Licensed in
MN
In the registry since
2010
Specialties on file
2
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Practice location Address checks out

6500 Excelsior Blvd
St Louis Park, MN 55426-4702
Phone: (952) 993-3123
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence A0810006 (MN)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence G0810008 (MN)

Record details

NPI number1396055851
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedOctober 19, 2010
Last updated in NPPESOctober 19, 2010

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2010 (16 years in practice)
Group practice Park Nicollet Clinic — 1773 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

Other providers in St Louis Park