Provider Demographics
NPI:1922380930
Name:RAUCH, SUZANNE LYONS (PA-C)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:LYONS
Last Name:RAUCH
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2222 E HIGHLAND AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-4876
Mailing Address - Country:US
Mailing Address - Phone:602-264-4834
Mailing Address - Fax:602-254-5178
Practice Address - Street 1:2222 E HIGHLAND AVE STE 204
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-4876
Practice Address - Country:US
Practice Address - Phone:602-264-4834
Practice Address - Fax:602-254-5178
Is Sole Proprietor?:No
Enumeration Date:2011-09-15
Last Update Date:2020-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZ4957363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant