Provider Demographics
NPI:1043400393
Name:RASMUSSEN, MARY E (REGNURSE)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:REGNURSE
Other - Prefix:
Other - First Name:BETSY
Other - Middle Name:ELIZABETH
Other - Last Name:RASMUSSEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:REGNURSE
Mailing Address - Street 1:275 PETIT AVE
Mailing Address - Street 2:
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93004-1743
Mailing Address - Country:US
Mailing Address - Phone:805-647-5381
Mailing Address - Fax:
Practice Address - Street 1:300 HILLMONT AVE
Practice Address - Street 2:
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003-1651
Practice Address - Country:US
Practice Address - Phone:805-652-3200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-01
Last Update Date:2007-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA531408163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse