Provider Demographics
NPI:1245217710
Name:RASMUSSEN, KATHLEEN ANN
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:KATHLEEN
Other - Middle Name:ANN
Other - Last Name:LOCKETT
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3851 ROGER BROOKE DR
Mailing Address - Street 2:MCHE-DOR
Mailing Address - City:FORT SAM HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:78234-4501
Mailing Address - Country:US
Mailing Address - Phone:210-916-2585
Mailing Address - Fax:210-916-2922
Practice Address - Street 1:3851 ROGER BROOKE DR
Practice Address - Street 2:MCHE-DOR
Practice Address - City:FORT SAM HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:78234-4501
Practice Address - Country:US
Practice Address - Phone:210-916-2585
Practice Address - Fax:210-916-2922
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other