Provider Demographics
NPI:1174802896
Name:LAINE, ALAINA MARIE (RN, CNP)
Entity type:Individual
Prefix:
First Name:ALAINA
Middle Name:MARIE
Last Name:LAINE
Suffix:
Gender:F
Credentials:RN, CNP
Other - Prefix:
Other - First Name:ALAINA
Other - Middle Name:MARIE
Other - Last Name:MATZKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, CNP
Mailing Address - Street 1:200 UNIVERSITY AVE E
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55101-2507
Mailing Address - Country:US
Mailing Address - Phone:651-325-2307
Mailing Address - Fax:651-229-1713
Practice Address - Street 1:200 UNIVERSITY AVE E
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-2507
Practice Address - Country:US
Practice Address - Phone:651-325-2307
Practice Address - Fax:651-229-1713
Is Sole Proprietor?:No
Enumeration Date:2011-08-11
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR-181452-5363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner