Provider Demographics
NPI:1467826255
Name:RAUSCHENBACH, SADIE S (PA-C)
Entity Type:Individual
Prefix:
First Name:SADIE
Middle Name:S
Last Name:RAUSCHENBACH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1110 E ST PETER ST.
Mailing Address - Street 2:
Mailing Address - City:NEW IBERIA
Mailing Address - State:LA
Mailing Address - Zip Code:70560
Mailing Address - Country:US
Mailing Address - Phone:337-364-1166
Mailing Address - Fax:337-364-7090
Practice Address - Street 1:1110 E SAINT PETER ST
Practice Address - Street 2:
Practice Address - City:NEW IBERIA
Practice Address - State:LA
Practice Address - Zip Code:70560-3932
Practice Address - Country:US
Practice Address - Phone:337-364-1166
Practice Address - Fax:337-364-7090
Is Sole Proprietor?:No
Enumeration Date:2015-11-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA300549363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical