Healthcare Provider Details

I. General information

NPI: 1184504110
Provider Name (Legal Business Name): LAUREN BROOKE RAUH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/02/2025
Last Update Date: 09/02/2025
Certification Date: 09/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7021 HARPS MILL RD STE 100
RALEIGH NC
27615-3240
US

IV. Provider business mailing address

85 NOBLE HEART PL
FUQUAY VARINA NC
27526-3448
US

V. Phone/Fax

Practice location:
  • Phone: 919-576-8480
  • Fax:
Mailing address:
  • Phone: 845-443-6901
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP2201X
TaxonomyAmbulatory Care Registered Nurse
License Number358003
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: