Provider Demographics
NPI:1740268036
Name:RASMUSSEN, NORMAN HANS (EDD)
Entity type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:HANS
Last Name:RASMUSSEN
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2390 CORAL RIDGE PL NE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55906
Mailing Address - Country:US
Mailing Address - Phone:507-282-3732
Mailing Address - Fax:
Practice Address - Street 1:3265 19TH STREET NW, HIGHLANDS ON 19TH
Practice Address - Street 2:SUITE #370
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901
Practice Address - Country:US
Practice Address - Phone:507-269-8590
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2018-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNLP2731103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN811047600Medicaid
MN680000010Medicare ID - Type Unspecified
MN811047600Medicaid
MN680009918Medicare ID - Type UnspecifiedRAILROAD