MEDICARE: REBECCA RAE KALTON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174H00000X	Health Educator
2	171400000X	Health & Wellness Coach

General Provider Information

NPI Number	:	1225921547
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	REBECCA RAE KALTON

Provider Business Mailing Address
First Line	:	2024 S 6TH ST
Second Line	:
City	:	BRAINERD
State	:	MN
Zip	:	56401-4529
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	29018 HUXTABLE POINT RD
Second Line	:
City	:	MERRIFIELD
State	:	MN
Zip	:	56465-4338
Country	:	US
Telephone Number	:	218-820-8114
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/03/2025
Last Update Date	:	06/03/2025

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Directions to “ REBECCA RAE KALTON ” Practice Location

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