Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | 5356 | MN |
NPI | 1033627039 |
---|---|
Provider Name | Alena Deutschlander |
First Address | Underwood, MN 56586-9262 |
Second Address | Elbow Lake, MN 56531-4645 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/01/2018 |
Last Update Date | 12/01/2018 |