Alexandra Denise Disrud, PA-C

NPI #1053831487 in Summit, Wisconsin

Provider Information

NPI Number: 1053831487
Entity Type: Individual
Name: Alexandra Denise Disrud, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Jun 27, 2017
Last Updated: Dec 1, 2021

Practice Location

Address: 36500 AURORA DR
City: Summit
State: Wisconsin
ZIP Code: 53066
Phone: (262) 434-1000

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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