Provider Demographics
NPI:1851126874
Name:RAUSCH, CAROLINE NYMAN (CPNP-PC)
Entity type:Individual
Prefix:MS
First Name:CAROLINE
Middle Name:NYMAN
Last Name:RAUSCH
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2363 N CRESTLINE CT
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67205-1574
Mailing Address - Country:US
Mailing Address - Phone:316-648-6484
Mailing Address - Fax:
Practice Address - Street 1:2363 N CRESTLINE CT
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1574
Practice Address - Country:US
Practice Address - Phone:316-648-6484
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-09
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS14-153001163WP0200X
KS202428371363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatricsGroup - Single Specialty
No163WP0200XNursing Service ProvidersRegistered NursePediatrics