Healthcare Provider Details

I. General information

NPI: 1154383719
Provider Name (Legal Business Name): ANN K RASMUSSEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/06/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 E SPRING ST
ANTHONY KS
67003-2122
US

IV. Provider business mailing address

1101 E SPRING ST
ANTHONY KS
67003-2122
US

V. Phone/Fax

Practice location:
  • Phone: 620-842-5144
  • Fax:
Mailing address:
  • Phone: 620-842-5144
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number0527298
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: