Provider Demographics
NPI:1104256122
Name:RAUCCI, ASHLEY
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:
Last Name:RAUCCI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2035 E 7TH ST
Mailing Address - Street 2:APT 5
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16511-1815
Mailing Address - Country:US
Mailing Address - Phone:814-920-0816
Mailing Address - Fax:
Practice Address - Street 1:2035 E 7TH ST
Practice Address - Street 2:APT 5
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16511-1815
Practice Address - Country:US
Practice Address - Phone:814-920-0816
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPN287076164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse