Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2100X | Nurse Practitioner - Acute Care | AP7761 | AZ |
N | 363LA2100X | Nurse Practitioner - Acute Care | RN128788 | AZ |
NPI | 1013394063 |
---|---|
Provider Name | Ms. Nicole J Rauscher |
First Address | Phoenix, AZ 85032-2136 |
Second Address | Phoenix, AZ 85032-2136 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2015 |
Last Update Date | 23/04/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
071193 | (05) | AZ |
Z223858 | MEDICARE (01) | AZ |