=====================================================
General NPI Number Information
=====================================================
NPI Number | 1922959246
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MR. ALEX DAVID HEARN
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/04/2026
-----------------------------------------------------
Last Update Date | 02/04/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 7720 47 1/2 PL N
-----------------------------------------------------
City | NEW HOPE
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55428-4503
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-289-5700
-----------------------------------------------------
Fax | 612-289-5700
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 9705 45TH AVE N UNIT 41041
-----------------------------------------------------
City | MINNEAPOLIS
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 55441-1105
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 612-289-5700
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 171400000X
-----------------------------------------------------
Taxonomy Name | Health & Wellness Coach
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------