Provider Demographics
NPI:1972507739
Name:RAWSKY, ELAINE M (GNP)
Entity Type:Individual
Prefix:
First Name:ELAINE
Middle Name:M
Last Name:RAWSKY
Suffix:
Gender:F
Credentials:GNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3399 E GRAND RIVER AVE
Mailing Address - Street 2:STE 204
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-7555
Mailing Address - Country:US
Mailing Address - Phone:517-540-0709
Mailing Address - Fax:517-540-1775
Practice Address - Street 1:3399 E GRAND RIVER AVE
Practice Address - Street 2:STE 204
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-7555
Practice Address - Country:US
Practice Address - Phone:517-540-0709
Practice Address - Fax:517-540-1775
Is Sole Proprietor?:No
Enumeration Date:2005-06-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI163WG0100X
MI4704147728163WG0100X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WG0100XNursing Service ProvidersRegistered NurseGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0N97800001Medicare PIN
MIS72331Medicare UPIN