Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
REBECCA J LIETZOW, FNP
ActiveREBECCA J LIETZOW, FNP is a Adult Health Nurse Practitioner healthcare provider located in FOREST LAKE, Minnesota. NPI 1538450630 is currently active in the NPPES registry. Verify at CMS.
Adult Health Nurse Practitioner · FOREST LAKE, MN
Registration Details
- NPI Number
- 1538450630
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 22, 2011 (15.307147667628 yrs)
- Last Updated
- Dec 8, 2023
- Licenses
-
141323 (WI)R-168269-2 (MN)4164 (MN)6572 (WI)
Practice Information
- Address
-
1540 LAKE ST SFOREST LAKE, MN, 550252628Browse MN providers · Browse ZIP 55025
- Phone
- 6514647100
- Fax
- 6512411515
- Primary Specialty
-
Adult Health Nurse Practitioner
363LA2200X
- Additional Specialty
- Critical Care Nurse
- Additional Specialty
- Adult Health Nurse Practitioner
- Additional Specialty
- Family Nurse Practitioner
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.