1821285396 NPI number — MRS. MIKAL TESS RASMUSSEN ARNP

Table of content: MRS. MIKAL TESS RASMUSSEN ARNP (NPI 1821285396)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1821285396 NPI number — MRS. MIKAL TESS RASMUSSEN ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RASMUSSEN
Provider First Name:
MIKAL
Provider Middle Name:
TESS
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MORIARTY
Provider Other First Name:
MIKAL
Provider Other Middle Name:
TESS
Provider Other Name Prefix Text:
MISS
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1821285396
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/14/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1609 N. ANKENY BLVD SUITE #200
Provider Second Line Business Mailing Address:
ACUTE CARE, INC
Provider Business Mailing Address City Name:
ANKENY
Provider Business Mailing Address State Name:
IA
Provider Business Mailing Address Postal Code:
50023
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-729-7813
Provider Business Mailing Address Fax Number:
515-964-2466

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1609 N. ANKENY BLVD SUITE #200
Provider Second Line Business Practice Location Address:
ACUTE CARE, INC
Provider Business Practice Location Address City Name:
ANKENY
Provider Business Practice Location Address State Name:
IA
Provider Business Practice Location Address Postal Code:
50023
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-729-7813
Provider Business Practice Location Address Fax Number:
515-964-2466
Provider Enumeration Date:
09/28/2007

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: 363LF0000X , with the licence number:  A114402 , registered in the state of IA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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