Wirtz, Rebecca M

Wirtz, Rebecca M is an individual health care provider with primary practice located at 523 N 3Rd St , Brainerd MN 56401-3054. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Wirtz, Rebecca M can be contacted via phone (218) 829-2861.

Contact Information

Primary practice address
523 N 3Rd St Brainerd MN 56401-3054
Phone: (218) 829-2861
Fax: (218) 454-5843
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X R1570490 Minnesota

Profile Details

NPI number 1619950292
LBN Legal business name Wirtz, Rebecca M
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 28th, 2005
Last updated Jan 15th, 2016 - about 10 years ago

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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Identifiers

StateTypeNumberIssuer
All States NPI 1619950292 NPPES
Minnesota MEDICAID 440079800

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