Healthcare Provider Details

I. General information

NPI: 1639966773
Provider Name (Legal Business Name): ALEXA RAUNIG FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/22/2025
Last Update Date: 09/28/2026
Certification Date: 09/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1803 S RIDGEVIEW RD
OLATHE KS
66062-2376
US

IV. Provider business mailing address

11755 W 112TH ST
OVERLAND PARK KS
66210-2742
US

V. Phone/Fax

Practice location:
  • Phone: 913-829-0505
  • Fax: 913-338-1311
Mailing address:
  • Phone: 913-469-0503
  • Fax: 913-338-1311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number53-85491
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: