Healthcare Provider Details

I. General information

NPI: 1942738596
Provider Name (Legal Business Name): ANNIE JOSEPHINE JANE PAULSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANN JOSEPHINE JANE LILJEGREN APRN, CNM

II. Dates (important events)

Enumeration Date: 05/26/2017
Last Update Date: 10/20/2025
Certification Date: 10/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 17TH AVE E
ALEXANDRIA MN
56308-5273
US

IV. Provider business mailing address

610 30TH AVE W
ALEXANDRIA MN
56308-3426
US

V. Phone/Fax

Practice location:
  • Phone: 320-763-7883
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number341
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: