Healthcare Provider Details

I. General information

NPI: 1437039005
Provider Name (Legal Business Name): ALYSSA ECKDAHL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2025
Last Update Date: 01/04/2026
Certification Date: 01/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 UNION ST NE
CHATFIELD MN
55923-1018
US

IV. Provider business mailing address

104 UNION ST NE
CHATFIELD MN
55923-1018
US

V. Phone/Fax

Practice location:
  • Phone: 507-273-1797
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License Number2460104
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: