Individual
REBECCA M WIRTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
(218) 454-5843
Mailing address
523 N 3RD ST, BRAINERD, MN 56401-3054
(218) 829-2861
(218) 454-5843
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1570490
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
440079800
—
MN
Enumeration date
11/28/2005
Last updated
01/15/2016
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