Provider Demographics
NPI:1619181625
Name:RASMUSSEN, SHARON D (RN,RNFA)
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:D
Last Name:RASMUSSEN
Suffix:
Gender:F
Credentials:RN,RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5540 W 111TH ST
Mailing Address - Street 2:
Mailing Address - City:OAK LAWN
Mailing Address - State:IL
Mailing Address - Zip Code:60453-5574
Mailing Address - Country:US
Mailing Address - Phone:708-423-8440
Mailing Address - Fax:708-423-6335
Practice Address - Street 1:5540 W 111TH ST
Practice Address - Street 2:
Practice Address - City:OAK LAWN
Practice Address - State:IL
Practice Address - Zip Code:60453-5574
Practice Address - Country:US
Practice Address - Phone:708-423-8440
Practice Address - Fax:708-423-6335
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical