Provider Demographics
NPI:1588543078
Name:SKLUZACEK, REBECCA PAMELA (DNP)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:PAMELA
Last Name:SKLUZACEK
Suffix:
Gender:F
Credentials:DNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:844 11TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:LONSDALE
Mailing Address - State:MN
Mailing Address - Zip Code:55046-2308
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:844 11TH AVE NE
Practice Address - Street 2:
Practice Address - City:LONSDALE
Practice Address - State:MN
Practice Address - Zip Code:55046-2308
Practice Address - Country:US
Practice Address - Phone:507-339-8408
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-08-28
Last Update Date:2025-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2018414163W00000X
MN3223367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse