Provider Demographics
NPI:1972592244
Name:RAPACH, EDWARD P (CRNA)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:P
Last Name:RAPACH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:945 BETHESDA DRIVE
Mailing Address - Street 2:200B
Mailing Address - City:ZANESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43701-1406
Mailing Address - Country:US
Mailing Address - Phone:740-455-4937
Mailing Address - Fax:740-455-4931
Practice Address - Street 1:2951 MAPLE AVENUE
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1406
Practice Address - Country:US
Practice Address - Phone:614-864-6171
Practice Address - Fax:614-864-7674
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2009-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHRN245631207L00000X
OHNA07374207L00000X
OHCOA.07374-NA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2413892Medicaid
OH2413892Medicaid
OHRA8236181Medicare PIN