Individual
RACHEL L LIEBENOW
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
500 S MAPLE ST, WACONIA, MN 55387-1752
(952) 442-2191
Mailing address
500 SOUTH MAPLE STREET, WACONIA, MN 55387
(952) 442-2191
(651) 968-5904
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8908
MN
Other
Enumeration date
08/23/2006
Last updated
03/17/2018
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