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NPI Code Detail

MEDICARE: MRS. SHARON D RASMUSSEN RN,RNFA

MEDICARE: MRS. SHARON D RASMUSSEN RN,RNFA
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
1363AS0400XSurgical Physician Assistant

General Provider Information

NPI Number : 1619181625
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. SHARON D RASMUSSEN RN,RNFA
Provider Business Mailing Address
First Line : 5540 W 111TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-5574
Country : US
Telephone Number : 708-423-8440
Fax Number : 708-423-6335
Provider Business Practice Location Address
First Line : 5540 W 111TH ST
Second Line :
City : OAK LAWN
State : IL
Zip : 60453-5574
Country : US
Telephone Number : 708-423-8440
Fax Number : 708-423-6335
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/09/2007
Last Update Date : 07/08/2007

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