Provider Demographics
NPI:1750310868
Name:COUCH, RAE LYNN (ARNP)
Entity Type:Individual
Prefix:
First Name:RAE LYNN
Middle Name:
Last Name:COUCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:RAE LYNN
Other - Middle Name:
Other - Last Name:SCHUSTER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:PO BOX 635283
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-5283
Mailing Address - Country:US
Mailing Address - Phone:859-331-6466
Mailing Address - Fax:859-344-7930
Practice Address - Street 1:4900 HOUSTON RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-4824
Practice Address - Country:US
Practice Address - Phone:859-331-6466
Practice Address - Fax:859-344-7930
Is Sole Proprietor?:No
Enumeration Date:2006-07-01
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY3002292363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH3090364Medicaid
KY78002656Medicaid
KY500007561OtherRAILROAD MEDICARE
KYP00883411OtherRAILROAD MEDICARE
KYS70288Medicare UPIN
KYP00883411OtherRAILROAD MEDICARE
KY008580020Medicare PIN