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Individual
ALEXIS RUPP MACIEJ
Active
Individual
ALEXIS RUPP MACIEJ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
1138
MN
363LP0200X
Pediatric Nurse Practitioner
R 146818-8
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0599746
—
IA
01
—
1046051
PREFERREDONE
—
01
—
12-03425
MEDICA - CHOICE
—
01
—
12-09026
MEDICAID PRIMARY
—
01
—
135386
UCARE
—
01
—
2393329
ARAZ
—
05
—
41270300
—
WI
05
—
4306627
—
MT
01
—
631T4MA
BLUE CROSS BLUE SHIELD
MN
05
—
994940200
—
MN
01
—
B675
TRICARE/TRIWEST
—
01
—
HP56959
HEALTHPARTNERS
MN
Enumeration date
10/20/2006
Last updated
11/28/2023
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