Provider Demographics
NPI:1770219321
Name:AUXANO PSYCHIATRIC NP SERVICES, PLLC
Entity Type:Organization
Organization Name:AUXANO PSYCHIATRIC NP SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHIATRIC NURSE PRACTITIONER
Authorized Official - Prefix:MS
Authorized Official - First Name:CAROLE
Authorized Official - Middle Name:A
Authorized Official - Last Name:RUMBERGER
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:518-980-9810
Mailing Address - Street 1:516 WASHINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:NY
Mailing Address - Zip Code:12144-1440
Mailing Address - Country:US
Mailing Address - Phone:518-980-9810
Mailing Address - Fax:518-980-9818
Practice Address - Street 1:516 WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:NY
Practice Address - Zip Code:12144-1440
Practice Address - Country:US
Practice Address - Phone:518-980-9810
Practice Address - Fax:518-980-9818
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-07-26
Last Update Date:2023-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty