Provider Demographics
NPI:1093764268
Name:REES, RHODA M (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:RHODA
Middle Name:M
Last Name:REES
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:RHODA
Other - Middle Name:M
Other - Last Name:BYLER REES
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:400 E 3RD ST
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55805-1951
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:13060 ISLE DR
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8331
Practice Address - Country:US
Practice Address - Phone:218-828-2880
Practice Address - Fax:218-454-5916
Is Sole Proprietor?:No
Enumeration Date:2006-05-08
Last Update Date:2019-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1567363L00000X
MN961363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI43935600Medicaid
WI0365 20195Medicare ID - Type Unspecified
WI43935600Medicaid