MEDICARE: MS. CYNTHIA K RAU-SOBOTKA CRNA

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	367500000X	Certified Registered Nurse Anesthetist	79222	CO

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1699746107
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. CYNTHIA K RAU-SOBOTKA CRNA

Provider Business Mailing Address
First Line	:	PO BOX 150
Second Line	:
City	:	HOLLY
State	:	CO
Zip	:	81047-0150
Country	:	US
Telephone Number	:	719-537-0712
Fax Number	:	719-537-6284

Provider Business Practice Location Address
First Line	:	4231 W 16TH AVE
Second Line	:
City	:	DENVER
State	:	CO
Zip	:	80204-1335
Country	:	US
Telephone Number	:	719-537-0712
Fax Number	:	719-537-6284

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

Provider Enumeration Date	:	02/01/2006
Last Update Date	:	07/08/2007

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