Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Alexandra Lynn Liethen

Individual provider Physician Assistant · NPI 1508754979

Alexandra Lynn Liethen is a Physician Assistant in Maple Grove, Minnesota. Qualified in 2025, 1 year ago. Practices with Minneapolis Clinic of Neurology Ltd, a 75-clinician group, accepts Medicare assignment and offers telehealth.

Years since qualifying
1
In the registry since
2025
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Practice location Address checks out

9645 Grove Cir N Ste 100
Maple Grove, MN 55369-2682
Phone: (763) 302-4114
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X

Record details

NPI number1508754979
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedJune 25, 2025
Last updated in NPPESJune 25, 2025
Certification dateJune 25, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2025 (1 years in practice)
Group practice Minneapolis Clinic Of Neurology Ltd — 75 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

Other providers in Maple Grove