# ALEXIS RUPP MACIEJ

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1902988421
- **Gender:** F
- **Credential:** PNP

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0200X | Pediatric Nurse Practitioner | 1138 | MN | Yes |
| 363LP0200X | Pediatric Nurse Practitioner | R 146818-8 | MN | — |

## Other

- **Enumeration date:** 10/20/2006
- **Last updated:** 11/28/2023

## 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 |