Provider Demographics
NPI:1396824918
Name:RAHE, NANCY MARIE (ARNP)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:MARIE
Last Name:RAHE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2346 MORMON TREK BLVD
Mailing Address - Street 2:STE 1500
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4371
Mailing Address - Country:US
Mailing Address - Phone:319-337-7642
Mailing Address - Fax:319-339-1449
Practice Address - Street 1:3 LIONS DR
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9575
Practice Address - Country:US
Practice Address - Phone:319-467-5050
Practice Address - Fax:319-467-7130
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2016-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA108489363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP00634369OtherRR MEDICARE
IA0733535Medicaid
IA1396824918Medicaid
IA0733535Medicaid
IAI1416006Medicare PIN
IAI1421014Medicare PIN