Basic Information
Provider Information
NPI: 1255926291
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: FINN
FirstName: ALEXANDER
MiddleName: DANIEL
NamePrefix:  
NameSuffix:  
Credential:  
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Mailing Information
Address1: GIM, 2ND FLOOR
Address2: 1008 SOUTH SPRING
City: ST. LOUIS
State: MO
PostalCode: 631102520
CountryCode: US
TelephoneNumber: 3142578222
FaxNumber: 3142578221
Practice Location
Address1: 1201 S GRAND BLVD
Address2:  
City: SAINT LOUIS
State: MO
PostalCode: 631041016
CountryCode: US
TelephoneNumber: 3145778000
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/02/2021
LastUpdateDate: 05/21/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
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IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/10/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163WC0200X2013005219MON Nursing Service ProvidersRegistered NurseCritical Care Medicine
363LA2100X2021008447MOY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care

No ID Information.


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