Basic Information
Provider Information
NPI: 1073681052
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KALINA
FirstName: ALEXANDRIA
MiddleName: CAMPBELL
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6413 CHEROKEE TRL
Address2:  
City: EDINA
State: MN
PostalCode: 554391106
CountryCode: US
TelephoneNumber: 9529432909
FaxNumber:  
Practice Location
Address1: 1805 HENNEPIN AVE N
Address2:  
City: GLENCOE
State: MN
PostalCode: 553361416
CountryCode: US
TelephoneNumber: 3208643121
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/30/2006
LastUpdateDate: 11/25/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 11/25/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
208000000X33432MNY Allopathic & Osteopathic PhysiciansPediatrics 

No ID Information.


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