Provider Demographics
NPI:1093050700
Name:RASMUSSEN, CHELSEA ANN (PHARMACY TECHNICIAN)
Entity Type:Individual
Prefix:
First Name:CHELSEA
Middle Name:ANN
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:PHARMACY TECHNICIAN
Other - Prefix:
Other - First Name:CHELSEA
Other - Middle Name:ANN
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMACY TECHNICIAN
Mailing Address - Street 1:3500 TOWER AVE
Mailing Address - Street 2:ESSENTIA HEALTH SUPERIOR PHARMACY
Mailing Address - City:SUPERIOR
Mailing Address - State:WI
Mailing Address - Zip Code:54880-5395
Mailing Address - Country:US
Mailing Address - Phone:715-817-7880
Mailing Address - Fax:715-395-3176
Practice Address - Street 1:3500 TOWER AVE
Practice Address - Street 2:ESSENTIA HEALTH SUPERIOR PHARMACY
Practice Address - City:SUPERIOR
Practice Address - State:WI
Practice Address - Zip Code:54880-5395
Practice Address - Country:US
Practice Address - Phone:715-817-7880
Practice Address - Fax:715-395-3176
Is Sole Proprietor?:No
Enumeration Date:2012-12-06
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN711243183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician