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Individual

ALEXIS RUPP

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 365-1000
Mailing address
16322 25TH ST S, LAKELAND, MN 55043-9732
(651) 329-1435

Taxonomy

Speciality
Code
Description
License number
State
163WC0200X
Critical Care Medicine Registered Nurse
RN 18159-9
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA 1993
MN

Other

Enumeration date
11/01/2016
Last updated
12/11/2016
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