Healthcare Provider Details

I. General information

NPI: 1538997838
Provider Name (Legal Business Name): ELEXUS STOWERS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/26/2024
Last Update Date: 07/26/2024
Certification Date: 07/20/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20288 MN 15 SUITE 100
HUTCHINSON MN
55350
US

IV. Provider business mailing address

20288 MN 15 SUITE 100
HUTCHINSON MN
55350
US

V. Phone/Fax

Practice location:
  • Phone: 320-244-2437
  • Fax: 320-234-6358
Mailing address:
  • Phone: 320-244-2437
  • Fax: 320-234-6358

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: