Provider Demographics
NPI:1689312597
Name:RAUSCH, STEPHEN T
Entity Type:Individual
Prefix:
First Name:STEPHEN
Middle Name:T
Last Name:RAUSCH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 13579
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19612-3579
Mailing Address - Country:US
Mailing Address - Phone:148-465-9216
Mailing Address - Fax:
Practice Address - Street 1:4860 PENN AVE
Practice Address - Street 2:
Practice Address - City:SINKING SPRING
Practice Address - State:PA
Practice Address - Zip Code:19608-8601
Practice Address - Country:US
Practice Address - Phone:484-659-1520
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-23
Last Update Date:2022-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN588487163W00000X
PASP025793363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse