Provider Demographics
NPI:1629588934
Name:RASMUSSEN, SEAN (FNP)
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11272 S RICK CIR
Mailing Address - Street 2:
Mailing Address - City:SOUTH JORDAN
Mailing Address - State:UT
Mailing Address - Zip Code:84095-4001
Mailing Address - Country:US
Mailing Address - Phone:435-890-0209
Mailing Address - Fax:
Practice Address - Street 1:10011 S CENTENNIAL PKWY STE 350
Practice Address - Street 2:
Practice Address - City:SANDY
Practice Address - State:UT
Practice Address - Zip Code:84070-4137
Practice Address - Country:US
Practice Address - Phone:801-566-5350
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-10-02
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT6837840-4405363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty