Basic Information
| Provider Information | |||||||||
| NPI: | 1013596097 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CAUSA | ||||||||
| FirstName: | THERESA | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | DNP, APRN, FNP-BC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 291195 | ||||||||
| Address2: | |||||||||
| City: | SAN ANTONIO | ||||||||
| State: | TX | ||||||||
| PostalCode: | 782291795 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2104919400 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | GREAT PLAINS HEALTH | ||||||||
| Address2: | 601 W LEOTA ST | ||||||||
| City: | NORTH PLATTE | ||||||||
| State: | NE | ||||||||
| PostalCode: | 691013500 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3085688000 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/06/2021 | ||||||||
| LastUpdateDate: | 03/10/2022 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 10/14/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 1015712 | TX | N | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 363LP0808X | 1015712 | TX | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Psych/Mental Health |
No ID Information.