Healthcare Provider Details

I. General information

NPI: 1629928346
Provider Name (Legal Business Name): REBECCA KATHERINE ENGDAHL D.N.P., APRN, C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2026
Last Update Date: 07/20/2026
Certification Date: 07/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

207 3RD ST NE
KASSON MN
55944-1564
US

IV. Provider business mailing address

207 3RD ST NE
KASSON MN
55944-1564
US

V. Phone/Fax

Practice location:
  • Phone: 507-951-8597
  • Fax: 507-951-8597
Mailing address:
  • Phone: 507-951-8597
  • Fax: 507-951-8597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1573086
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: