Alexis Marie Hanevold, OT | |
625 Demers Ave, East Grand Forks, MN 56721-1833 | |
(218) 773-5858 | |
Not Available |
Full Name | Alexis Marie Hanevold |
---|---|
Gender | Female |
Speciality | Occupational Therapy |
Experience | 5 Years |
Location | 625 Demers Ave, East Grand Forks, Minnesota |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1841849320 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
225X00000X | Occupational Therapist | 1738 (North Dakota) | Secondary |
225X00000X | Occupational Therapist | 106041 (Minnesota) | Primary |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Sanford Medical Center Fargo | 8426967803 | 1085 |
Sanford Medical Center Fargo | 8426967803 | 1085 |
Provider Name | Sanford Clinic North |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1548532468 PECOS PAC ID: 4284546151 Enrollment ID: O20031209000264 |
Provider Name | Sanford Medical Center Fargo |
---|---|
Provider Type | Part B Supplier - Clinic/group Practice |
Provider Identifiers | NPI Number: 1184917924 PECOS PAC ID: 8426967803 Enrollment ID: O20110701000031 |
Mailing Address | Practice Location Address |
---|---|
Alexis Marie Hanevold, OT 625 Demers Ave, East Grand Forks, MN 56721-1833 Ph: (218) 773-5858 | Alexis Marie Hanevold, OT 625 Demers Ave, East Grand Forks, MN 56721-1833 Ph: (218) 773-5858 |
Lisa Jean Jeffrey Brown, OTR/L Occupational Therapist Medicare: Medicare Enrolled Practice Location: 1505 Central Ave Nw, East Grand Forks, MN 56721 Phone: 701-739-6403 | |
Juan Rosales Jr., Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 823 17th St Nw, East Grand Forks, MN 56721 Phone: 701-741-0239 |