Individual
KELLY S. RASMUSSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
1340 CHARLES ST, ROCKFORD, IL 61104-2200
(779) 696-5888
(779) 696-5898
Mailing address
PO BOX 1567, ROCKFORD, IL 61110-0067
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
209-016202
IL
363L00000X
Nurse Practitioner
4227
WI
Other
Enumeration date
10/21/2010
Last updated
03/17/2018
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