Healthcare Provider Details

I. General information

NPI: 1316862550
Provider Name (Legal Business Name): KENDRA RAE RAUK DNP, FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/13/2026
Last Update Date: 08/13/2026
Certification Date: 08/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

440 N HIAWATHA DR
CANTON SD
57013-5800
US

IV. Provider business mailing address

300 S 1ST ST
BEAVER CREEK MN
56116-1118
US

V. Phone/Fax

Practice location:
  • Phone: 507-440-8003
  • Fax:
Mailing address:
  • Phone: 507-440-8003
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number201482
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: