Healthcare Provider Details

I. General information

NPI: 1720234941
Provider Name (Legal Business Name): JANET LYNN RASMUSSEN VRAA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JANET LYNN RASMUSSEN MD

II. Dates (important events)

Enumeration Date: 08/08/2008
Last Update Date: 01/24/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1500 CURVE CREST BLVD W
STILLWATER MN
55082-6040
US

IV. Provider business mailing address

1500 CURVE CREST BLVD W
STILLWATER MN
55082-6040
US

V. Phone/Fax

Practice location:
  • Phone: 651-439-1234
  • Fax: 651-275-3389
Mailing address:
  • Phone: 651-439-1234
  • Fax: 651-275-3389

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number52039
License Number StateMN
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: