| 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 Therapist In Private Practice |
| Experience | 7 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 | 1198 |
| Sanford Medical Center Fargo | 8426967803 | 1198 |
| 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: O20110331000495 |
| Mailing Address | Practice Location Address |
|---|---|
| Alexis Marie Hanevold, OT Po Box 5074, Sioux Falls, SD 57117-5074 Ph: () - | 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 | |
Paige Nicole Simonson, Occupational Therapist Medicare: Not Enrolled in Medicare Practice Location: 625 Demers Ave, East Grand Forks, MN 56721 Phone: 218-773-5858 | |
Juan Rosales Jr., Occupational Therapist Medicare: Medicare Enrolled Practice Location: 823 17th St Nw, East Grand Forks, MN 56721 Phone: 701-741-0239 |