Individual
ALICIA MARIE ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
640 JACKSON ST, SAINT PAUL, MN 55101-2502
(651) 254-4887
Mailing address
7674 UPPER 171ST ST W, LAKEVILLE, MN 55044-7418
(507) 995-4827
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
7068
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7068
MN BOARD OF NURSING
MN
Enumeration date
11/14/2019
Last updated
05/13/2024
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