Individual
KELLY MARIE RASMUSSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
508 32ND AVE S APT 26, MOORHEAD, MN 56560-4972
(701) 866-6955
Mailing address
508 32ND AVE S APT 26, MOORHEAD, MN 56560-4972
(701) 866-6955
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
669551
MN
Other
Enumeration date
11/05/2024
Last updated
11/05/2024
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