Provider Demographics
NPI:1992933287
Name:LIEN, RENAE L (PHARMD)
Entity type:Individual
Prefix:
First Name:RENAE
Middle Name:L
Last Name:LIEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:712 CASCADE ST., S PO BOX 728
Mailing Address - Street 2:LAKE REGION HEALTHCARE CORPORATION
Mailing Address - City:FERGUS FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56538-0728
Mailing Address - Country:US
Mailing Address - Phone:651-329-8467
Mailing Address - Fax:
Practice Address - Street 1:712 CASCADE ST S
Practice Address - Street 2:LAKE REGION HEALTHCARE CORPORATION
Practice Address - City:FERGUS FALLS
Practice Address - State:MN
Practice Address - Zip Code:56538-0728
Practice Address - Country:US
Practice Address - Phone:651-329-8467
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-25
Last Update Date:2009-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN119621183500000X
ND5225183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist