Provider Demographics
NPI:1821285396
Name:RASMUSSEN, MIKAL TESS (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MIKAL
Middle Name:TESS
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MISS
Other - First Name:MIKAL
Other - Middle Name:TESS
Other - Last Name:MORIARTY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1609 N. ANKENY BLVD SUITE #200
Mailing Address - Street 2:ACUTE CARE, INC
Mailing Address - City:ANKENY
Mailing Address - State:IA
Mailing Address - Zip Code:50023
Mailing Address - Country:US
Mailing Address - Phone:800-729-7813
Mailing Address - Fax:515-964-2466
Practice Address - Street 1:1609 N. ANKENY BLVD SUITE #200
Practice Address - Street 2:ACUTE CARE, INC
Practice Address - City:ANKENY
Practice Address - State:IA
Practice Address - Zip Code:50023
Practice Address - Country:US
Practice Address - Phone:800-729-7813
Practice Address - Fax:515-964-2466
Is Sole Proprietor?:No
Enumeration Date:2007-09-28
Last Update Date:2009-10-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA114402363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAI1416004Medicare PIN