Individual
ALEXA MARIE DEROSIER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
3000 32ND AVE S, FARGO, ND 58103
(701) 364-8000
(701) 364-8078
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
R43698
ND
367A00000X
Advanced Practice Midwife
R43698
ND
Other
Enumeration date
02/04/2019
Last updated
12/15/2020
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