Provider Demographics
NPI:1609845833
Name:WOJCHIK, ALICIA J (NP)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:J
Last Name:WOJCHIK
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:ALICIA
Other - Middle Name:J
Other - Last Name:MIKKONEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:110105 PIONEER TRL W
Mailing Address - Street 2:SUITE 302
Mailing Address - City:CHASKA
Mailing Address - State:MN
Mailing Address - Zip Code:55318-2680
Mailing Address - Country:US
Mailing Address - Phone:952-361-5800
Mailing Address - Fax:952-361-5858
Practice Address - Street 1:110105 PIONEER TRL W
Practice Address - Street 2:SUITE 302
Practice Address - City:CHASKA
Practice Address - State:MN
Practice Address - Zip Code:55318-2680
Practice Address - Country:US
Practice Address - Phone:952-361-5800
Practice Address - Fax:952-361-5858
Is Sole Proprietor?:No
Enumeration Date:2006-03-17
Last Update Date:2016-04-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR143499-2363LA2200X, 363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN1045995OtherPREFERRED ONE
MNHP58493OtherHEALTHPARTNERS
MN182268OtherUCARE MN
MN331273900Medicaid
WI41272700Medicaid
MN0408045OtherMEDICA
MN2406641OtherAMERICA'S PPO
MN611K5WOOtherBLUE CROSS BLUE SHIELD MN
WI41272700Medicaid
MN331273900Medicaid