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NPI Code Detail

MEDICARE: SUSAN K. RAHN RN MS FNP

MEDICARE: SUSAN K. RAHN RN MS FNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363L00000XNurse Practitioner119161CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
4P01361490OTHERRAILROAD WORKERS MEDICARE FOR OLATHE COMM CLINIC DBA RIVER VALLEY FAMILY HEALTH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2RAR 66933OTHERBLUE CROSS
3840874926002OTHERCOROCKY MOUNTAIN HEALTHPLAN

General Provider Information

NPI Number : 1629070933
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUSAN K. RAHN RN MS FNP
Provider Business Mailing Address
First Line : 421 W EXCHANGE ST PO BOX 268
Second Line : BUSINESS OPTIONS MEDICAL BILLING
City : FREEPORT
State : IL
Zip : 61032-0268
Country : US
Telephone Number : 815-599-7950
Fax Number : 815-599-7974
Provider Business Practice Location Address
First Line : 1010 FAIRWAY DR
Second Line :
City : FREEPORT
State : IL
Zip : 61032-6600
Country : US
Telephone Number : 815-599-7740
Fax Number : 815-599-7650
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2005
Last Update Date : 11/02/2017

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