Provider Demographics
NPI:1710855994
Name:SHARIF-ISAACK, RUKIA YUSSUF
Entity type:Individual
Prefix:
First Name:RUKIA
Middle Name:YUSSUF
Last Name:SHARIF-ISAACK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1209 43 1/2 AVE NE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA HEIGHTS
Mailing Address - State:MN
Mailing Address - Zip Code:55421-3020
Mailing Address - Country:US
Mailing Address - Phone:612-978-0103
Mailing Address - Fax:
Practice Address - Street 1:1209 43 1/2 AVE NE
Practice Address - Street 2:
Practice Address - City:COLUMBIA HEIGHTS
Practice Address - State:MN
Practice Address - Zip Code:55421-3020
Practice Address - Country:US
Practice Address - Phone:612-978-0103
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-28
Last Update Date:2025-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN825186164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes164W00000XNursing Service ProvidersLicensed Practical NurseGroup - Single Specialty