Provider Demographics
NPI:1043767072
Name:KASTANEK, REBECCA (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:REBECCA
Middle Name:
Last Name:KASTANEK
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1406 6TH AVE N
Mailing Address - Street 2:REHABILITATION SERVICES ST.CLOUD HOSPITAL
Mailing Address - City:SAINT CLOUD
Mailing Address - State:MN
Mailing Address - Zip Code:56303-1900
Mailing Address - Country:US
Mailing Address - Phone:320-255-5740
Mailing Address - Fax:320-656-7155
Practice Address - Street 1:1406 6TH AVE N
Practice Address - Street 2:REHABILITATION SERVICES ST.CLOUD HOSPITAL
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-1900
Practice Address - Country:US
Practice Address - Phone:320-255-5740
Practice Address - Fax:320-656-7155
Is Sole Proprietor?:No
Enumeration Date:2016-09-07
Last Update Date:2023-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP4701363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily