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General NPI Number Information
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NPI Number | 1639998552
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Entity Type | Individual
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Provider Name | ALEXANDRA ROSE LAUDERDALE
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Gender | Female
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Dates
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Enumeration Date | 10/08/2024
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Last Update Date | 10/10/2025
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Provider Practice Location Address
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Address Line | 2450 RIVERSIDE AVE
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City | MINNEAPOLIS
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State | MN
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Zip | 55454-1450
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Country | US
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Telephone | 612-624-0720
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Fax |
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Provider Business Mailing Address
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Address Line | 1318 S MCCOY ST
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City | ABERDEEN
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State | SD
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Zip | 57401-7843
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Country | US
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Telephone | 605-377-4479
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LN0000X
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Taxonomy Name | Neonatal Nurse Practitioner
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License Number | 12263
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 163WN0002X
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Taxonomy Name | Neonatal Intensive Care Registered Nurse
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License Number | 2477446
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License Number State | MN
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