Basic Information
| Provider Information | |||||||||
| NPI: | 1376999276 | ||||||||
| EntityType: | 1 | ||||||||
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| LastName: | PFLAUM | ||||||||
| FirstName: | ALEXA | ||||||||
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| Mailing Information | |||||||||
| Address1: | 32269 335TH AVE | ||||||||
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| City: | LAKE CITY | ||||||||
| State: | MN | ||||||||
| PostalCode: | 550413353 | ||||||||
| CountryCode: | US | ||||||||
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| Practice Location | |||||||||
| Address1: | 111 COLCHESTER AVE | ||||||||
| Address2: | |||||||||
| City: | BURLINGTON | ||||||||
| State: | VT | ||||||||
| PostalCode: | 054011473 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8028472700 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/10/2016 | ||||||||
| LastUpdateDate: | 04/02/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 04/02/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 042-0015134 | VT | Y | Allopathic & Osteopathic Physicians | Anesthesiology | 390200000X | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.