Individual
PRISCILLA T RASAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
3 N. MANATEE STREET, BRAZIL, IN 47834-1513
(931) 253-1110
Mailing address
6626 E 75TH ST, SUITE 500, INDIANAPOLIS, IN 46250-2805
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71005600A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201346580
—
IN
01
—
P01824795
RR MEDICARE
IN
Enumeration date
02/22/2016
Last updated
12/11/2024
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