Healthcare Provider Details

I. General information

NPI: 1568187888
Provider Name (Legal Business Name): RACHEL ANNE TOLKINEN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2022
Last Update Date: 10/10/2022
Certification Date: 10/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6500 EXCELSIOR BLVD
ST LOUIS PARK MN
55426-4700
US

IV. Provider business mailing address

688 RIVER BIRCH PL
LINO LAKES MN
55014-1950
US

V. Phone/Fax

Practice location:
  • Phone: 952-993-5000
  • Fax:
Mailing address:
  • Phone: 651-492-4965
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number2457591
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: