Provider Demographics
NPI:1306710280
Name:RASK, PAITEN
Entity type:Individual
Prefix:
First Name:PAITEN
Middle Name:
Last Name:RASK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2351 CONNECTICUT AVE S STE 200
Mailing Address - Street 2:
Mailing Address - City:SARTELL
Mailing Address - State:MN
Mailing Address - Zip Code:56377-2477
Mailing Address - Country:US
Mailing Address - Phone:320-493-5007
Mailing Address - Fax:
Practice Address - Street 1:2351 CONNECTICUT AVE S STE 200
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-2477
Practice Address - Country:US
Practice Address - Phone:320-259-1411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-10-02
Last Update Date:2025-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN13425363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily