Provider Demographics
NPI:1942937388
Name:TRAUSCH, CARLY JANE (ARNP)
Entity Type:Individual
Prefix:
First Name:CARLY
Middle Name:JANE
Last Name:TRAUSCH
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6800 LAKE DR STE 285
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-2544
Mailing Address - Country:US
Mailing Address - Phone:515-226-3116
Mailing Address - Fax:
Practice Address - Street 1:421 VIKING PLAZA DR STE 200
Practice Address - Street 2:
Practice Address - City:CEDAR FALLS
Practice Address - State:IA
Practice Address - Zip Code:50613-6988
Practice Address - Country:US
Practice Address - Phone:319-531-9384
Practice Address - Fax:319-531-1164
Is Sole Proprietor?:No
Enumeration Date:2022-08-05
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA170531363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily