Individual
SUSAN RAUCKMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4231 W 16TH AVE, DENVER, CO 80204-1335
(719) 537-0712
Mailing address
PO BOX 150, HOLLY, CO 81047-0150
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
175575
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11971266
—
CO
Enumeration date
07/12/2006
Last updated
07/08/2007
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