Healthcare Provider Details

I. General information

NPI: 1427888965
Provider Name (Legal Business Name): RACHEL ANN LALIBERTE PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2024
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7500 OLSON MEMORIAL HWY STE 300
GOLDEN VALLEY MN
55427-4888
US

IV. Provider business mailing address

589 155TH AVE
SOMERSET WI
54025-7000
US

V. Phone/Fax

Practice location:
  • Phone: 651-271-1665
  • Fax: 612-999-1767
Mailing address:
  • Phone: 651-600-5783
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: