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General NPI Number Information
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NPI Number | 1316610454
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Entity Type | Individual
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Provider Name | JESSICA RAUKER
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Gender | Female
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Dates
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Enumeration Date | 07/26/2021
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Last Update Date | 03/26/2025
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Provider Practice Location Address
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Address Line | 315 S SETH CHILD RD
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City | MANHATTAN
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State | KS
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Zip | 66502-3003
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Country | US
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Telephone | 785-776-2813
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Fax |
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Provider Business Mailing Address
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Address Line | 8570 WILLIAM DR
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City | MANHATTAN
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State | KS
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Zip | 66502-8637
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Country | US
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Telephone | 781-660-0256
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 53-84168-052
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License Number State | KS
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