Provider Demographics
NPI:1326836040
Name:RAUSCH, KELLI SUZANNE (APRN)
Entity type:Individual
Prefix:
First Name:KELLI
Middle Name:SUZANNE
Last Name:RAUSCH
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8158 VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:LENEXA
Mailing Address - State:KS
Mailing Address - Zip Code:66220-2509
Mailing Address - Country:US
Mailing Address - Phone:231-342-6867
Mailing Address - Fax:
Practice Address - Street 1:3510 CLINTON PKWY # 310
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66047-2145
Practice Address - Country:US
Practice Address - Phone:231-342-6867
Practice Address - Fax:231-342-6867
Is Sole Proprietor?:No
Enumeration Date:2025-04-30
Last Update Date:2025-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-154029-111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse