1669673422 NPI number — WENDY L RASMUSSEN

Table of content: WENDY L RASMUSSEN (NPI 1669673422)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669673422 NPI number — WENDY L RASMUSSEN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
RASMUSSEN
Provider First Name:
WENDY
Provider Middle Name:
L
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SEAMAN
Provider Other First Name:
WENDY
Provider Other Middle Name:
L
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669673422
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/09/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
243 ELM ST
Provider Second Line Business Mailing Address:
VALLEY REGIONAL HOSPITAL
Provider Business Mailing Address City Name:
CLAREMONT
Provider Business Mailing Address State Name:
NH
Provider Business Mailing Address Postal Code:
03743-4921
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
603-542-7771
Provider Business Mailing Address Fax Number:
603-542-3403

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
243 ELM ST
Provider Second Line Business Practice Location Address:
VALLEY REGIONAL HOSPITAL
Provider Business Practice Location Address City Name:
CLAREMONT
Provider Business Practice Location Address State Name:
NH
Provider Business Practice Location Address Postal Code:
03743-4921
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
603-542-7771
Provider Business Practice Location Address Fax Number:
603-542-3403
Provider Enumeration Date:
05/30/2007

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: 231H00000X , with the licence number:  A429 , registered in the state of NH ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 0RE5640 , issued by the state of ( VT ) . This identifiers is of the category "MEDICAID".




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