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NPI Code Detail

MEDICARE: GINA RASNIC APRN

MEDICARE: GINA RASNIC APRN
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
1363LP0808XPsychiatric/Mental Health Nurse Practitioner53-77357-062KS

General Provider Information

NPI Number : 1679924633
Entity Type Code : Individual
Provider Name (Legal Business Name) : GINA RASNIC APRN
Provider Business Mailing Address
First Line : 1811 WAKARUSA DR STE 102
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2082
Country : US
Telephone Number : 785-371-4921
Fax Number : 888-965-5147
Provider Business Practice Location Address
First Line : 1811 WAKARUSA DR STE 102
Second Line :
City : LAWRENCE
State : KS
Zip : 66047-2082
Country : US
Telephone Number : 785-371-4921
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/30/2016
Last Update Date : 09/26/2020

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