Lietzow, Rebecca J

Lietzow, Rebecca J is an individual health care provider with primary practice located at 1540 Lake St S , Forest Lake MN 55025-2628. She recently has 4 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Adult Health, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Adult Health is her primary health care specialty. Lietzow, Rebecca J can be contacted via phone (651) 464-7100.

Contact Information

Primary practice address
1540 Lake St S Forest Lake MN 55025-2628
Phone: (651) 464-7100
Fax: (651) 241-1515
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 141323 Wisconsin
Nursing Service Providers / Critical Care Medicine 163WC0200X R-168269-2 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Adult Health 363LA2200X 4164 Minnesota
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 6572 Wisconsin

Profile Details

NPI number 1538450630
LBN Legal business name Lietzow, Rebecca J
Credentials Family Nurse Practitioner (FNP)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 22nd, 2011
Last updated Dec 8th, 2023 - about last year

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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