Healthcare Provider Details

I. General information

NPI: 1619029576
Provider Name (Legal Business Name): ANNA F RASMUSSEN R.N.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

330 CENTRAL AVE
NEW PROVIDENCE NJ
07974-2352
US

IV. Provider business mailing address

78 CROSS RD
CEDAR KNOLLS NJ
07927-1015
US

V. Phone/Fax

Practice location:
  • Phone: 908-508-1345
  • Fax: 608-508-1358
Mailing address:
  • Phone: 973-605-8762
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License Number26NO05240000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: