Provider Demographics
NPI:1184461329
Name:LEIFERMANN, RACHEL LYNN (RN, BSN)
Entity type:Individual
Prefix:
First Name:RACHEL
Middle Name:LYNN
Last Name:LEIFERMANN
Suffix:
Gender:F
Credentials:RN, BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13812 ROSE DR
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:MN
Mailing Address - Zip Code:55374-7512
Mailing Address - Country:US
Mailing Address - Phone:612-598-8884
Mailing Address - Fax:
Practice Address - Street 1:13812 ROSE DR
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:MN
Practice Address - Zip Code:55374-7512
Practice Address - Country:US
Practice Address - Phone:612-598-8884
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-07-15
Last Update Date:2024-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2483324163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse