=====================================================
General NPI Number Information
=====================================================
NPI Number | 1619029576
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANNA F RASMUSSEN R.N.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/18/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 330 CENTRAL AVE
-----------------------------------------------------
City | NEW PROVIDENCE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07974-2352
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 908-508-1345
-----------------------------------------------------
Fax | 608-508-1358
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 78 CROSS RD
-----------------------------------------------------
City | CEDAR KNOLLS
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 07927-1015
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 973-605-8762
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 163WS0200X
-----------------------------------------------------
Taxonomy Name | School Registered Nurse
-----------------------------------------------------
License Number | 26NO05240000
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------