MEDICARE: MARK A. RASMUSSON PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	10168	MN

General Provider Information

NPI Number	:	1023116522
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARK A. RASMUSSON PA

Provider Business Mailing Address
First Line	:	713 HORMEL CENTURY PKWY
Second Line	:
City	:	AUSTIN
State	:	MN
Zip	:	55912-3663
Country	:	US
Telephone Number	:	507-200-2344
Fax Number	:	833-464-3752

Provider Business Practice Location Address
First Line	:	713 HORMEL CENTURY PKWY
Second Line	:
City	:	AUSTIN
State	:	MN
Zip	:	55912-3663
Country	:	US
Telephone Number	:	507-200-2344
Fax Number	:	833-464-3752

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/20/2006
Last Update Date	:	07/18/2023

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