Provider Demographics
NPI:1689048498
Name:KINS, ALEKSANDR
Entity Type:Individual
Prefix:
First Name:ALEKSANDR
Middle Name:
Last Name:KINS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3300 OAKDALE AVE N
Mailing Address - Street 2:
Mailing Address - City:ROBBINSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55422-2926
Mailing Address - Country:US
Mailing Address - Phone:763-581-3980
Mailing Address - Fax:763-581-3591
Practice Address - Street 1:3300 OAKDALE AVE N
Practice Address - Street 2:
Practice Address - City:ROBBINSDALE
Practice Address - State:MN
Practice Address - Zip Code:55422-2926
Practice Address - Country:US
Practice Address - Phone:763-581-3980
Practice Address - Fax:763-581-3591
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2019-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO109759367500000X
MN2470285367500000X
WV76078163W00000X
PARN654307163W00000X
OHRN.419766163W00000X
CO1619598163W00000X
NVRN74673163W00000X
FLRN9423630163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
No367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered