Provider Demographics
NPI:1891779799
Name:KAJANDER, REBECCA LYNN (RN, MPH, CNP)
Entity Type:Individual
Prefix:MS
First Name:REBECCA
Middle Name:LYNN
Last Name:KAJANDER
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Gender:F
Credentials:RN, MPH, CNP
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Other - First Name:
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Mailing Address - Street 1:2828 CHICAGO AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55407-1320
Mailing Address - Country:US
Mailing Address - Phone:612-879-1000
Mailing Address - Fax:612-879-9116
Practice Address - Street 1:2828 CHICAGO AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55407-1320
Practice Address - Country:US
Practice Address - Phone:612-879-1000
Practice Address - Fax:612-879-9116
Is Sole Proprietor?:No
Enumeration Date:2005-12-05
Last Update Date:2011-02-09
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MNR066129-0363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
S75310Medicare UPIN