Individual
ALEXANDRA MALKUCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
301 BECKER AVE SW, WILLMAR, MN 56201-3302
(320) 253-4543
Mailing address
143 LAKE AVE N, SPICER, MN 56288-9616
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
10167
MN
367500000X
Certified Registered Nurse Anesthetist
Primary
120311
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/05/2017
Last updated
05/01/2023
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