Provider Demographics
NPI:1831322494
Name:RASMUSSEN, CHANDRA MICHELE (FNP-BC)
Entity Type:Individual
Prefix:
First Name:CHANDRA
Middle Name:MICHELE
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9900 BIRCH RUN RD
Mailing Address - Street 2:
Mailing Address - City:BIRCH RUN
Mailing Address - State:MI
Mailing Address - Zip Code:48415-9609
Mailing Address - Country:US
Mailing Address - Phone:989-624-1500
Mailing Address - Fax:989-624-1506
Practice Address - Street 1:9900 BIRCH RUN RD
Practice Address - Street 2:
Practice Address - City:BIRCH RUN
Practice Address - State:MI
Practice Address - Zip Code:48415-9609
Practice Address - Country:US
Practice Address - Phone:989-624-1515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-31
Last Update Date:2023-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704251080363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily