Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Rebecca J Lietzow, FNP

Individual provider Registered Nurse · NPI 1538450630

Rebecca J Lietzow, FNP is a Nurse Practitioner in Forest Lake, Minnesota. Qualified in 2015, 11 years ago. Practices with Ladd Memorial Hospital, a 71-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Minnesota and Wisconsin.

Years since qualifying
11
Licensed in
MN, WI
In the registry since
2011
Specialties on file
4
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

See every abbreviation used in this directory →

Practice location Address checks out

1540 Lake St S
Forest Lake, MN 55025-2628
Phone: (651) 464-7100
Fax: (651) 241-1515
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 235 E State St, Saint Croix Falls, WI 54024-4117 — (715) 483-3221

Specialties & licences

Adult Health Nurse Practitioner (primary) Taxonomy 363LA2200X · Licence 4164 (MN)
Registered Nurse Taxonomy 163W00000X · Licence 141323 (WI)
Critical Care Medicine Registered Nurse Taxonomy 163WC0200X · Licence R-168269-2 (MN)
Family Nurse Practitioner Taxonomy 363LF0000X · Licence 6572 (WI)

Record details

NPI number1538450630
Entity typeIndividual (Type 1)
GenderFemale
Credentials FNP
Sole proprietorNo
NPI enumeratedApril 22, 2011
Last updated in NPPESDecember 8, 2023
Certification dateDecember 8, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2015 (11 years in practice)
Group practice Ladd Memorial Hospital — 71 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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