Healthcare Provider Details

I. General information

NPI: 1295841062
Provider Name (Legal Business Name): REBECCA ANN WEHRENBERG PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: REBECCA ANN MUELLER PA-C

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 09/08/2025
Certification Date: 09/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

500 OSBORNE RD NE STE 200
FRIDLEY MN
55432-2768
US

IV. Provider business mailing address

2925 CHICAGO AVE
MINNEAPOLIS MN
55407-1321
US

V. Phone/Fax

Practice location:
  • Phone: 952-946-9777
  • Fax: 952-946-9888
Mailing address:
  • Phone: 612-262-9000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number9665
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: