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REBECCA LENORE ERTSGAARD PA-C NPI 1629623525


NPI Information

NPI: 1629623525
Provider Name: REBECCA LENORE ERTSGAARD, PA-C
Classification: Psychiatry & Neurology - 2084N0400X
Entity Type: Individual

Specialization: Neurology

PECOS Registration: Yes

Address:
11091 ULYSSES ST NE STE 100
BLAINE, MN
ZIP 55434
Phone: (612) 879-1000
Get Directions

Rebecca Lenore Ertsgaard, PA-C is a neurology psychiatry neurology in Blaine, MN with 5 years of experience. The provider is a Neurologist specializes in the diagnosis and treatment of diseases or impaired function of the brain, spinal cord, peripheral nerves, muscles, autonomic nervous system, and blood vessels that relate to these structures. Rebecca Lenore Ertsgaard, PA-C NPI is 1629623525. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

11091 ULYSSES ST NE STE 100
BLAINE, MN
ZIP 55434-238
Phone: (612) 879-1000
Fax: (612) 879-0722

The NPI 1629623525 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 8/7/2019 and was last updated on 7/30/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12084N0400XPsychiatry & NeurologyNeurology10352MINNESOTAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

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