Individual
MS. REBEKAH RUTH RICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
10 4TH AVE SE, GLENWOOD, MN 56334-1820
(320) 634-5157
(320) 634-2253
Mailing address
10 4TH AVE SE, GLENWOOD, MN 56334-1820
(320) 634-5157
(320) 634-2253
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA 06720
TX
363AM0700X
Medical Physician Assistant
Primary
9825
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
490R7RI
BLUE CROSS HOSPITAL
MN
05
—
717613900
—
MN
01
—
HP42449
HEALTH PARTNERS
MN
01
—
NA9091043263
PREFERRED ONE
MN
Enumeration date
05/26/2006
Last updated
12/15/2020
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