Blackmon, Alexandria Denise
Blackmon, Alexandria Denise is an individual health care provider with primary practice located at University Of Minnesota Physicians 516 Delaware Street Se, Pwb First Floor, Clinic 1E, Minneapolis MN 55455. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner is her primary health care specialty. Blackmon, Alexandria Denise can be contacted via phone (612) 626-6666.Contact Information
Primary practice address
University Of Minnesota Physicians 516 Delaware Street Se, Pwb First Floor, Clinic 1E
Minneapolis MN 55455
Phone: (612) 626-6666
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner | 363L00000X | R 146110-1 | Minnesota |
Physician Assistants & Advanced Practice Nursing Providers / Gerontology | 363LG0600X | R 146110-1 | Minnesota |
Profile Details
NPI number | 1407892672 |
---|---|
LBN Legal business name | Blackmon, Alexandria Denise |
Credentials | Nurse Practitioner (NP) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jun 22nd, 2006 |
Last updated | Aug 17th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1407892672 | NPPES |
Minnesota | Other | 2386128 | ARAZ |
Minnesota | MEDICAID | 0599241 | ARAZ |
Minnesota | MEDICAID | 083447500 | ARAZ |
Minnesota | Other | 135259 | ARAZ |
Minnesota | MEDICAID | 4307035 | ARAZ |
Minnesota | Other | HP56036 | ARAZ |
Minnesota | Other | 04-07907 | ARAZ |
Minnesota | Other | B678 | ARAZ |
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