Provider Demographics
NPI:1063908564
Name:LITERSKI, ALEXANDRA MAE (OD)
Entity type:Individual
Prefix:DR
First Name:ALEXANDRA
Middle Name:MAE
Last Name:LITERSKI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:N20634 PINE CREEK RIDGE RD
Mailing Address - Street 2:
Mailing Address - City:DODGE
Mailing Address - State:WI
Mailing Address - Zip Code:54625-9723
Mailing Address - Country:US
Mailing Address - Phone:507-450-3028
Mailing Address - Fax:
Practice Address - Street 1:2950 CURVE CREST BLVD W
Practice Address - Street 2:
Practice Address - City:STILLWATER
Practice Address - State:MN
Practice Address - Zip Code:55082-5085
Practice Address - Country:US
Practice Address - Phone:651-275-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-09
Last Update Date:2018-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN3581152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN3581OtherSTATE LICENSING NUMBER