Provider Demographics
NPI:1104010826
Name:RAWLINSON, MICHELLE M (RN)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:M
Last Name:RAWLINSON
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 1:1115 N 950 W
Mailing Address - Street 2:
Mailing Address - City:OREM
Mailing Address - State:UT
Mailing Address - Zip Code:84057-2851
Mailing Address - Country:US
Mailing Address - Phone:801-687-1399
Mailing Address - Fax:
Practice Address - Street 1:1115 N 950 W
Practice Address - Street 2:
Practice Address - City:OREM
Practice Address - State:UT
Practice Address - Zip Code:84057-2851
Practice Address - Country:US
Practice Address - Phone:801-687-1399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT336738-3102163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse