1467443069 NPI number — DEBORAH PETERSON RASMUSSEN M.D.

Table of content: DEBORAH PETERSON RASMUSSEN M.D. (NPI 1467443069)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1467443069 NPI number — DEBORAH PETERSON RASMUSSEN M.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RASMUSSEN
Provider First Name:
DEBORAH
Provider Middle Name:
PETERSON
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
M.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1467443069
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/07/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20 9TH ST SE
Provider Second Line Business Mailing Address:
CENTRACARE HEALTH SYSTEM-LONG PRAIRIE
Provider Business Mailing Address City Name:
LONG PRAIRIE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
56347-1404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
320-732-2131
Provider Business Mailing Address Fax Number:
320-732-6913

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
20 9TH ST SE
Provider Second Line Business Practice Location Address:
CENTRACARE HEALTH SYSTEM-LONG PRAIRIE
Provider Business Practice Location Address City Name:
LONG PRAIRIE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
56347-1404
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
320-732-2131
Provider Business Practice Location Address Fax Number:
320-732-6913
Provider Enumeration Date:
11/02/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  31728 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 767132 . This is a "ARAZ GROUP AMERICAS PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: HP21164 . This is a "HEALTH PARTNERS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2114036 . This is a "FIRST HEALTH" identifier . This identifiers is of the category "OTHER".
  • Identifier: 31728 . This is a "MN LICENSE NUMBER" identifier . This identifiers is of the category "OTHER".
  • Identifier: 54Q38RA . This is a "BLUE CROSS BLUE SHIELD" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0119793 . This is a "MEDICA HEALTH PLANS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 1006862 . This is a "PREFERRED ONE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 111431 . This is a "U CARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 282802200 . This is a "MEDICAL ASSISTANCE" identifier . This identifiers is of the category "OTHER".




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