Provider Demographics
NPI:1104142116
Name:RAUCH, STARR LYNN (CRNA)
Entity type:Individual
Prefix:
First Name:STARR
Middle Name:LYNN
Last Name:RAUCH
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:STARR
Other - Middle Name:LYNN
Other - Last Name:FEDDERS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 5045
Mailing Address - Street 2:ATTN: PATIENT FINANCIAL SERVICES, ADP2
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5045
Mailing Address - Country:US
Mailing Address - Phone:605-322-6428
Mailing Address - Fax:605-322-6499
Practice Address - Street 1:800 E 21ST ST
Practice Address - Street 2:AVERA MCKENNAN ANESTHESIOLOGY
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57105-1016
Practice Address - Country:US
Practice Address - Phone:605-322-2754
Practice Address - Fax:605-322-2727
Is Sole Proprietor?:No
Enumeration Date:2010-04-15
Last Update Date:2025-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDCR000736367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
9292961OtherDAKOTACARE
MN1104142116Medicaid
SD2000118Medicaid
NE46022474348Medicaid
MN1104142116OtherBCBS MN
1104142116OtherWELLMARK BCBS - TRICARE
IA1104142116Medicaid
MN1104142116Medicaid