Healthcare Provider Details

I. General information

NPI: 1851042832
Provider Name (Legal Business Name): CASE ROD RASMUSSEN CRNA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/12/2022
Last Update Date: 09/16/2026
Certification Date: 09/16/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1200 S COLUMBIA RD
GRAND FORKS ND
58201-4044
US

IV. Provider business mailing address

3162 W 5925 S
ROY UT
84067-9182
US

V. Phone/Fax

Practice location:
  • Phone: 701-780-5000
  • Fax:
Mailing address:
  • Phone: 801-388-6973
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number8994741-4406
License Number StateUT
# 2
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number8994741-8901
License Number StateUT
# 3
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number3367
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: