Provider Demographics
NPI:1154746089
Name:RAUEN, ADELE KATHERINE (PA)
Entity type:Individual
Prefix:
First Name:ADELE
Middle Name:KATHERINE
Last Name:RAUEN
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7690 DISCOVERY DR
Mailing Address - Street 2:
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-6542
Mailing Address - Country:US
Mailing Address - Phone:513-475-8400
Mailing Address - Fax:513-475-8228
Practice Address - Street 1:7690 DISCOVERY DR
Practice Address - Street 2:
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-6542
Practice Address - Country:US
Practice Address - Phone:513-475-8400
Practice Address - Fax:513-475-8228
Is Sole Proprietor?:No
Enumeration Date:2014-03-01
Last Update Date:2016-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH50-003992363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant