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NPI Code Detail

MEDICARE: ANGEL RASMUSSEN

MEDICARE:   ANGEL  RASMUSSEN
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1386060069
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANGEL RASMUSSEN
Provider Business Mailing Address
First Line : 6112 RIDGECARN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-1372
Country : US
Telephone Number : 920-203-1142
Fax Number :
Provider Business Practice Location Address
First Line : 6112 RIDGECARN AVE
Second Line :
City : LAS VEGAS
State : NV
Zip : 89130-1372
Country : US
Telephone Number : 920-203-1142
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/05/2014
Last Update Date : 03/05/2014

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Directions to “ ANGEL RASMUSSEN ” Practice Location

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