Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | C110006788 | DE |
Y | 207RN0300X | Nephrologist | 49619 | MN |
NPI | 1043298854 |
---|---|
Provider Name | Alexandra E Straight |
First Address | Brooklyn Center, MN 55430-2128 |
Second Address | Roseville, MN 55113-6807 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/01/2006 |
Last Update Date | 11/03/2021 |