Provider Demographics
NPI:1649477068
Name:HABERMAN, HEATHER RASMUSSEN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:HEATHER
Middle Name:RASMUSSEN
Last Name:HABERMAN
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2551 38TH AVE NE UNIT 206
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-5008
Mailing Address - Country:US
Mailing Address - Phone:713-256-6685
Mailing Address - Fax:
Practice Address - Street 1:401 PHALEN BLVD MSC 41102B
Practice Address - Street 2:
Practice Address - City:SAINT PAUL
Practice Address - State:MN
Practice Address - Zip Code:55101-5302
Practice Address - Country:US
Practice Address - Phone:651-254-7580
Practice Address - Fax:651-254-7584
Is Sole Proprietor?:No
Enumeration Date:2007-06-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN10254363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant