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General NPI Number Information
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NPI Number | 1386570174
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Entity Type | Individual
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Provider Name | JOHANNA ROSE RASCH MSN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 06/20/2026
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Last Update Date | 06/20/2026
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Provider Practice Location Address
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Address Line | 260 JEFFERSON AVE SE STE 100
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City | GRAND RAPIDS
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State | MI
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Zip | 49503-6300
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Country | US
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Telephone | 616-336-3909
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Fax |
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Provider Business Mailing Address
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Address Line | 2479 MELBY ST
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City | CASNOVIA
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State | MI
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Zip | 49318-9504
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 4704376221
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License Number State | MI
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