MEDICARE: EMILY LYNN RAUCHUT PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA.0009617	CO

General Provider Information

NPI Number	:	1003773896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMILY LYNN RAUCHUT PA

Provider Business Mailing Address
First Line	:	12625 HIGHLAND OAKS PL
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80921-3675
Country	:	US
Telephone Number	:	719-439-3095
Fax Number	:

Provider Business Practice Location Address
First Line	:	6031 E WOODMEN RD STE 300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-2624
Country	:	US
Telephone Number	:	719-521-3391
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/06/2026
Last Update Date	:	01/06/2026

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