Healthcare Provider Details

I. General information

NPI: 1083536916
Provider Name (Legal Business Name): KIMBERLY RASMUSSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/30/2026
Last Update Date: 07/30/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 E MEDICAL CTR DR
ST GEORGE UT
84790-2123
US

IV. Provider business mailing address

1723 W 950 N
ST GEORGE UT
84770-4956
US

V. Phone/Fax

Practice location:
  • Phone: 435-251-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number6842515-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: