Healthcare Provider Details

I. General information

NPI: 1750544581
Provider Name (Legal Business Name): CHRISTY M BORAAS ALSLEBEN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: DR. CHRISTY MARIE BORAAS

II. Dates (important events)

Enumeration Date: 07/02/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

606 24TH AVE S
MINNEAPOLIS MN
55454-1455
US

IV. Provider business mailing address

720 WASHINGTON AVE SE
MINNEAPOLIS MN
55414-2924
US

V. Phone/Fax

Practice location:
  • Phone: 612-273-7111
  • Fax: 612-273-7112
Mailing address:
  • Phone: 612-273-7111
  • Fax: 612-273-7112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number58304
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: