MEDICARE: KAROLINA ROSE RASMUSSEN

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	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1568326973
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAROLINA ROSE RASMUSSEN

Provider Business Mailing Address
First Line	:	1276 W RIVER ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83702-7066
Country	:	US
Telephone Number	:	208-338-4699
Fax Number	:

Provider Business Practice Location Address
First Line	:	1276 W RIVER ST
Second Line	:
City	:	BOISE
State	:	ID
Zip	:	83702-7066
Country	:	US
Telephone Number	:	208-338-4699
Fax Number	:

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

Provider Enumeration Date	:	12/10/2025
Last Update Date	:	12/10/2025

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Directions to “ KAROLINA ROSE RASMUSSEN ” Practice Location

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