Healthcare Provider Details

I. General information

NPI: 1629271119
Provider Name (Legal Business Name): ERIN RAUSCHER N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 09/13/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

64 DOUBLE HILL RD
BETHLEHEM CT
06751-1101
US

IV. Provider business mailing address

396 WASHINGTON ST #242
WELLESLEY HILLS MA
02481-6209
US

V. Phone/Fax

Practice location:
  • Phone: 203-884-8652
  • Fax:
Mailing address:
  • Phone: 602-578-5996
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberMA166385
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number7013
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: