Provider Demographics
NPI:1588482145
Name:RAUCH, MARIA JOSEPHINE (LPN)
Entity type:Individual
Prefix:MISS
First Name:MARIA
Middle Name:JOSEPHINE
Last Name:RAUCH
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 1:1301 W RIVER RD
Mailing Address - Street 2:
Mailing Address - City:LITTLE FALLS
Mailing Address - State:MN
Mailing Address - Zip Code:56345-4158
Mailing Address - Country:US
Mailing Address - Phone:320-232-5103
Mailing Address - Fax:
Practice Address - Street 1:722 NW 7TH ST
Practice Address - Street 2:
Practice Address - City:BRAINERD
Practice Address - State:MN
Practice Address - Zip Code:56401-2912
Practice Address - Country:US
Practice Address - Phone:218-855-1115
Practice Address - Fax:612-725-1302
Is Sole Proprietor?:No
Enumeration Date:2024-10-01
Last Update Date:2024-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN772118164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse