Provider Demographics
NPI:1669975272
Name:RAFFAELE, ERIN (FNP, ACNP)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:RAFFAELE
Suffix:
Gender:F
Credentials:FNP, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3330 N 2ND ST
Mailing Address - Street 2:STE 300
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85012-2369
Mailing Address - Country:US
Mailing Address - Phone:602-265-8965
Mailing Address - Fax:602-650-0578
Practice Address - Street 1:3330 N 2ND ST
Practice Address - Street 2:STE 300
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85012-2369
Practice Address - Country:US
Practice Address - Phone:602-265-8965
Practice Address - Fax:602-650-0578
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-10
Last Update Date:2023-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI13859363LA2100X, 363LG0600X
AZAP11051363LF0000X, 363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology