Provider Demographics
NPI:1225921547
Name:KALTON, REBECCA RAE
Entity type:Individual
Prefix:
First Name:REBECCA
Middle Name:RAE
Last Name:KALTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2024 S 6TH ST
Mailing Address - Street 2:
Mailing Address - City:BRAINERD
Mailing Address - State:MN
Mailing Address - Zip Code:56401-4529
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:29018 HUXTABLE POINT RD
Practice Address - Street 2:
Practice Address - City:MERRIFIELD
Practice Address - State:MN
Practice Address - Zip Code:56465-4338
Practice Address - Country:US
Practice Address - Phone:218-820-8114
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-06-03
Last Update Date:2025-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach
No174H00000XOther Service ProvidersHealth Educator