Provider Demographics
NPI:1558691600
Name:BORN, REBECCA LYNN (CERTIFIED PROSTHETIS)
Entity Type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:LYNN
Last Name:BORN
Suffix:
Gender:F
Credentials:CERTIFIED PROSTHETIS
Other - Prefix:
Other - First Name:REBECCA
Other - Middle Name:MICHELLE
Other - Last Name:LYNN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2025 EAST RIVER PARKWAY
Mailing Address - Street 2:SHRINERS HOSPITALS FOR CHILDREN TWIN CITIES
Mailing Address - City:MINNEAPOLIST
Mailing Address - State:MN
Mailing Address - Zip Code:55414-3604
Mailing Address - Country:US
Mailing Address - Phone:612-596-6100
Mailing Address - Fax:612-330-5954
Practice Address - Street 1:2025 EAST RIVER PARKWAY
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55414-3604
Practice Address - Country:US
Practice Address - Phone:612-596-6100
Practice Address - Fax:612-330-5954
Is Sole Proprietor?:No
Enumeration Date:2010-01-12
Last Update Date:2010-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist