Healthcare Provider Details

I. General information

NPI: 1629142856
Provider Name (Legal Business Name): CARA MICHELE RASMUSSEN AU D
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: CARA M ROE-RASMUSSEN AU D

II. Dates (important events)

Enumeration Date: 11/20/2006
Last Update Date: 06/30/2022
Certification Date: 06/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2825 28TH ST SE
GRAND RAPIDS MI
49512-1607
US

IV. Provider business mailing address

2848 BELLEGLADE CT SE
GRAND RAPIDS MI
49546-8011
US

V. Phone/Fax

Practice location:
  • Phone: 616-600-9650
  • Fax: 616-600-9650
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code237600000X
TaxonomyAudiologist-Hearing Aid Fitter
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number1601000208
License Number StateMI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: