Provider Demographics
NPI:1396739058
Name:RAHN, CYNTHIA SUE (CRNA)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:SUE
Last Name:RAHN
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:CYNTHIA
Other - Middle Name:SUE
Other - Last Name:MOORE-CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4100 PARK FOREST DR
Mailing Address - Street 2:SUITE 210
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49684-7331
Mailing Address - Country:US
Mailing Address - Phone:231-935-5770
Mailing Address - Fax:231-935-0747
Practice Address - Street 1:4100 PARK FOREST DR
Practice Address - Street 2:SUITE 210
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49684-7331
Practice Address - Country:US
Practice Address - Phone:231-935-5770
Practice Address - Fax:231-935-0747
Is Sole Proprietor?:No
Enumeration Date:2005-09-08
Last Update Date:2017-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704097645367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI1396739058Medicaid
MI430B810310OtherBCBS TSC
MI430052733OtherMEDICARE RAIL ROAD TSC
MI1396739058Medicaid