| Doctor Name: | REBECCA J LIETZOW |
| NPI Number: | 1538450630 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | FNP |
| License Number: | R-168269-2 |
| Business Practice Address: | 235 E State St Saint Croix Falls, WI - 540244117 |
| Business Phone Number: | 7154833221 |
| Business Fax Number: | 7154830507 |
| Mailing Address: | 235 E State St, SAINT CROIX FALLS |
| State: | WI |
| Postal Code: | 540244117 |
| Phone Number: | 7154833221 |
| Fax Number: | 7154830507 |
| NPI Enumeration Date: | 04/22/2011 |
| NPI Last Update Date: | 08/19/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WC0200X |
| License Number: | R-168269-2 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MN |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | Critical Care Medicine |
| Taxonomy Definition: | |