Healthcare Provider Details

I. General information

NPI: 1639915812
Provider Name (Legal Business Name): KAYLEE ALEXUS DEUTSCH PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/08/2024
Last Update Date: 10/21/2025
Certification Date: 10/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8450 SEASONS PKWY
WOODBURY MN
55125-4402
US

IV. Provider business mailing address

3769 75TH ST E
INVER GROVE HEIGHTS MN
55076-4361
US

V. Phone/Fax

Practice location:
  • Phone: 952-687-8103
  • Fax:
Mailing address:
  • Phone: 678-554-5213
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number126567
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: