MEDICARE: MS. MICHELLE RAFFERTY NP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN125196	AZ
2	363LG0600X	Gerontology Nurse Practitioner	AP3427	AZ
3	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	AP3427	AZ
4	363LA2200X	Adult Health Nurse Practitioner	AP3427	AZ

General Provider Information

NPI Number	:	1770715070
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE RAFFERTY NP

Provider Business Mailing Address
First Line	:	3901 W OASIS DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-9513
Country	:	US
Telephone Number	:	520-940-1119
Fax Number	:	520-744-6697

Provider Business Practice Location Address
First Line	:	3901 W OASIS DR
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-9513
Country	:	US
Telephone Number	:	520-940-1119
Fax Number	:	520-744-6697

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/20/2009
Last Update Date	:	12/13/2024

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