Provider Demographics
NPI:1295016129
Name:TOSTENSON, REBECCA JEANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:JEANNE
Last Name:TOSTENSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 KENILWORTH AVE N
Mailing Address - Street 2:
Mailing Address - City:LANESBORO
Mailing Address - State:MN
Mailing Address - Zip Code:55949-8001
Mailing Address - Country:US
Mailing Address - Phone:507-467-2419
Mailing Address - Fax:
Practice Address - Street 1:400 KENILWORTH AVE N
Practice Address - Street 2:
Practice Address - City:LANESBORO
Practice Address - State:MN
Practice Address - Zip Code:55949-8001
Practice Address - Country:US
Practice Address - Phone:507-467-2419
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-09-06
Last Update Date:2011-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR 136305-0163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse