Provider Demographics
NPI:1467139378
Name:RASMUSSEN, ABIGAIL JOY (CNP-BC)
Entity Type:Individual
Prefix:
First Name:ABIGAIL
Middle Name:JOY
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:CNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:687 S 160TH AVE
Mailing Address - Street 2:
Mailing Address - City:HOLLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49423-6776
Mailing Address - Country:US
Mailing Address - Phone:616-550-4872
Mailing Address - Fax:
Practice Address - Street 1:1920 E STATE HIGHWAY 114
Practice Address - Street 2:
Practice Address - City:SOUTHLAKE
Practice Address - State:TX
Practice Address - Zip Code:76092-6510
Practice Address - Country:US
Practice Address - Phone:817-442-5698
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-03
Last Update Date:2023-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1074747363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health