Healthcare Provider Details

I. General information

NPI: 1922959246
Provider Name (Legal Business Name): MR. ALEX DAVID HEARN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/04/2026
Last Update Date: 02/04/2026
Certification Date: 02/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7720 47 1/2 PL N
NEW HOPE MN
55428-4503
US

IV. Provider business mailing address

9705 45TH AVE N UNIT 41041
MINNEAPOLIS MN
55441-1105
US

V. Phone/Fax

Practice location:
  • Phone: 612-289-5700
  • Fax: 612-289-5700
Mailing address:
  • Phone: 612-289-5700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171400000X
TaxonomyHealth & Wellness Coach
License Number
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: