Individual
STEPHANIE L ALEXANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, CNP
Contact information
Practice address
115 10TH AVE NE STE A, DEER RIVER, MN 56636-8795
(218) 246-8275
(218) 246-8279
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
0024127876
VA
363L00000X
Nurse Practitioner
Primary
CNP498
MN
363LA2200X
Adult Health Nurse Practitioner
204077-0
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10001438
SENTARA
VA
01
—
204077-0
STATE LICENSE
MN
01
—
C06778
GROUP PTAN
VA
Enumeration date
08/01/2006
Last updated
03/07/2023
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