Provider Demographics
NPI:1649755539
Name:RAUSCH, SAMANTHA LEWIS (NP)
Entity Type:Individual
Prefix:
First Name:SAMANTHA
Middle Name:LEWIS
Last Name:RAUSCH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3799 N 50 E
Mailing Address - Street 2:
Mailing Address - City:GREENFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:46140-8626
Mailing Address - Country:US
Mailing Address - Phone:765-617-5959
Mailing Address - Fax:
Practice Address - Street 1:3799 N 50 E
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:IN
Practice Address - Zip Code:46140-8626
Practice Address - Country:US
Practice Address - Phone:765-617-5959
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-26
Last Update Date:2018-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF05180287363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily