Provider Demographics
NPI:1780568378
Name:SAKURETS, ALEXANDRA ISHKOVA (NP)
Entity type:Individual
Prefix:MRS
First Name:ALEXANDRA
Middle Name:ISHKOVA
Last Name:SAKURETS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 CENTRAL AVE NE STE 235
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55418-4530
Mailing Address - Country:US
Mailing Address - Phone:651-235-9972
Mailing Address - Fax:
Practice Address - Street 1:1920 CENTRAL AVE NE STE 235
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55418-4530
Practice Address - Country:US
Practice Address - Phone:651-235-9972
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-05
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN12990363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily