Healthcare Provider Details

I. General information

NPI: 1689486730
Provider Name (Legal Business Name): SUSAN LYNN LEHTO RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/24/2025
Last Update Date: 01/24/2025
Certification Date: 01/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

604 JONES AVE P.O. BOX 100
BUHL MN
55713
US

IV. Provider business mailing address

604 JONES AVE P.O. BOX 100
BUHL MN
55713
US

V. Phone/Fax

Practice location:
  • Phone: 218-258-6142
  • Fax:
Mailing address:
  • Phone: 218-258-6142
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberR154094-1
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: