Individual
MRS. KRISTEN DANIELLE RASMUSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
811 13TH STREET, SUITE 10, AUGUSTA, GA 30901
(706) 434-1590
(706) 434-1595
Mailing address
811 13TH STREET, SUITE 10, AUGUSTA, GA 30901
(706) 434-1590
(706) 434-1595
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005689
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005689
GEORGIA LICENSE
GA
01
—
1089725
PHYSICIAN ASSISTANT CERTIFICATION
GA
Enumeration date
09/08/2009
Last updated
12/08/2011
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