Individual
MRS. ALEXANDRA STAUM REIF
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP
Contact information
Practice address
1825 WOODWINDS DR, WOODBURY, MN 55125-2202
(651) 323-6700
Mailing address
1700 UNIVERSITY AVE W, PROVIDER ENROLLMENT, ST PAUL, MN 55104-3727
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
5236
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
245678-8
MN RN LICENSE
MN
01
—
5236
CNP
MN
Enumeration date
07/10/2017
Last updated
04/28/2022
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