Individual
JENNIFER LIETZAU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DNP, APRN, AGACNP-BC
Contact information
Practice address
1836 SOUTH AVE, LA CROSSE, WI 54601-5429
(608) 782-7300
Mailing address
208 ELM ST, STRUM, WI 54770-7905
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
4742-026
WI
363LA2200X
Adult Health Nurse Practitioner
Primary
11673
WI
Other
Enumeration date
08/28/2009
Last updated
02/07/2022
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