Healthcare Provider Details

I. General information

NPI: 1588784573
Provider Name (Legal Business Name): MONICA LIDDLE ND, LM, CPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/31/2007
Last Update Date: 05/12/2026
Certification Date: 05/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 E 9TH ST STE 110
DULUTH MN
55805-1604
US

IV. Provider business mailing address

1001 E 9TH ST STE 110
DULUTH MN
55805-1604
US

V. Phone/Fax

Practice location:
  • Phone: 218-940-0761
  • Fax: 218-520-0663
Mailing address:
  • Phone: 218-940-0761
  • Fax: 218-520-0663

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code176B00000X
TaxonomyMidwife
License Number1019
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code175F00000X
TaxonomyNaturopath
License Number1045
License Number StateMN
# 3
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number2949
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: