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NPI Code Detail

MEDICARE: EDWARD ANDREW RAUCH JR. DNP, APRN

MEDICARE: EDWARD ANDREW RAUCH JR. DNP, APRN
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
1363LC0200XCritical Care Medicine Nurse Practitioner26NJ15244200NJ
2163WC0200XCritical Care Medicine Registered Nurse26NR18209600NJ
3364SC0200XCritical Care Medicine Clinical Nurse Specialist26NJ15244200NJ

General Provider Information

NPI Number : 1164233060
Entity Type Code : Individual
Provider Name (Legal Business Name) : EDWARD ANDREW RAUCH JR. DNP, APRN
Provider Business Mailing Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : JBSA FT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 908-752-3513
Fax Number :
Provider Business Practice Location Address
First Line : 3551 ROGER BROOKE DR
Second Line :
City : JBSA FT SAM HOUSTON
State : TX
Zip : 78234-4504
Country : US
Telephone Number : 908-752-3513
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/20/2025
Last Update Date : 12/18/2025

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