Provider Demographics
NPI:1336435221
Name:RAUSCH, NANCY ANN (LPN)
Entity type:Individual
Prefix:MRS
First Name:NANCY
Middle Name:ANN
Last Name:RAUSCH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14510 PAYNE RD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-9105
Mailing Address - Country:US
Mailing Address - Phone:937-642-1534
Mailing Address - Fax:
Practice Address - Street 1:14510 PAYNE RD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-9105
Practice Address - Country:US
Practice Address - Phone:937-642-1534
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-20
Last Update Date:2011-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHP.N.040271164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse