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Contact Information

THERESA R BLY, APRN, CNP
300 S BRUCE ST
MARSHALL, MN56258-1934
 Phone: 507-537-9007
 Fax: 507-537-2720
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family

363LF0000X 50 Nurse Practitioner
 

Registered Nurse

163W00000X
Indicates primary specialty

NPI Profile & details for THERESA R BLY · (Female)

NPI Number 1760460836
Status Active
Credentials APRN, CNP
Entity Individual
Enumeration date 01/09/2006
Last updated 03/09/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • MN License # 0742
  • MN License # R 088633 4
  • MN Medicaid 816610200
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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