MEDICARE: ALEXANDRA HALICKE

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	817253	MN

General Provider Information

NPI Number	:	1427996321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA HALICKE

Provider Business Mailing Address
First Line	:	4801 VETERANS DR
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56303-2015
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1708 KILIAN BLVD SE
Second Line	:
City	:	SAINT CLOUD
State	:	MN
Zip	:	56304-2130
Country	:	US
Telephone Number	:	320-828-2215
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2026
Last Update Date	:	03/23/2026

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Directions to “ ALEXANDRA HALICKE ” Practice Location

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