Provider Demographics
NPI:1942572615
Name:RAFALKO, SHARON LYNN (RN)
Entity type:Individual
Prefix:MS
First Name:SHARON
Middle Name:LYNN
Last Name:RAFALKO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30800 TELEGRAPH RD STE. 2800
Mailing Address - Street 2:UNITED PHYSICIANS
Mailing Address - City:BINGHAMS FARMS
Mailing Address - State:MI
Mailing Address - Zip Code:48346
Mailing Address - Country:US
Mailing Address - Phone:248-593-0263
Mailing Address - Fax:248-593-0175
Practice Address - Street 1:30800 TELEGRAPH ROAD
Practice Address - Street 2:SUITE 2800 UNITED PHYSICIANS
Practice Address - City:BINGHAM FARMS
Practice Address - State:MI
Practice Address - Zip Code:48025
Practice Address - Country:US
Practice Address - Phone:248-593-0263
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-27
Last Update Date:2012-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704119032163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse