Provider Demographics
NPI:1528852720
Name:HARRISON, MICHELLE HELENA (RN)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:HELENA
Last Name:HARRISON
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 1:112 GABLE ST
Mailing Address - Street 2:
Mailing Address - City:FOLSOM
Mailing Address - State:CA
Mailing Address - Zip Code:95630-4635
Mailing Address - Country:US
Mailing Address - Phone:916-757-5150
Mailing Address - Fax:
Practice Address - Street 1:10359 S WHITE ROCK RD
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-5718
Practice Address - Country:US
Practice Address - Phone:916-294-9125
Practice Address - Fax:916-294-9024
Is Sole Proprietor?:No
Enumeration Date:2025-04-04
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA573730163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool