IndividualActive
Alexandra Liethen
NPI 1508754979 · Physician Assistant · Maple Grove, MN
Provider details
- NPI number
- 1508754979
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Sex
- Female
- Sole proprietor
- No
Practice location
9645 Grove Cir N Ste 100
Maple Grove, MN 55369-2682
Phone: (763) 302-4114
Mailing address
11050 Cedar Hills Blvd Apt 323
Minnetonka, MN 55305-3057
Registry dates
- Enumerated
- 2025-06-25
- Last updated
- 2025-06-25
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.