MEDICARE: ALEXANDRA ADELINE KRUEGER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC1900X	Counseling Psychologist

General Provider Information

NPI Number	:	1699617472
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRA ADELINE KRUEGER

Provider Business Mailing Address
First Line	:	5911 OXFORD ST APT 11
Second Line	:
City	:	ST LOUIS PARK
State	:	MN
Zip	:	55416-5000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	30 S 10TH ST
Second Line	:
City	:	MINNEAPOLIS
State	:	MN
Zip	:	55403-2033
Country	:	US
Telephone Number	:	651-962-4820
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/08/2026
Last Update Date	:	04/08/2026

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