Provider Demographics
NPI:1659086171
Name:SHRAUCHLE
Entity Type:Organization
Organization Name:SHRAUCHLE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CRNA
Authorized Official - Prefix:MRS
Authorized Official - First Name:SANDY
Authorized Official - Middle Name:LEIGH
Authorized Official - Last Name:HAMMON-RAUCHLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:417-861-2053
Mailing Address - Street 1:1671 FOXBORO CT
Mailing Address - Street 2:
Mailing Address - City:BENTONVILLE
Mailing Address - State:AR
Mailing Address - Zip Code:72713-9369
Mailing Address - Country:US
Mailing Address - Phone:417-861-2053
Mailing Address - Fax:
Practice Address - Street 1:3733 N BUSINESS DR # 3721
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:AR
Practice Address - Zip Code:72703-5203
Practice Address - Country:US
Practice Address - Phone:479-443-5476
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-18
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR1396249629OtherNPI