Individual
SCOTT J RAABE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R030947-0599
SD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100212
SD BLUE CROSS PROV #
SD
01
—
1700898657
WELLMARK BCBS TRICARE - AVERA FLANDREAU HOSPITAL
—
05
—
1700898657
—
IA
05
—
171613100
—
MN
01
—
174P1RA
MN BLUE CROSS PROV #
MN
05
—
460224743-48
—
NE
05
—
5754730
—
SD
01
—
R030947
DAKOTACARE
SD
Enumeration date
08/12/2006
Last updated
05/24/2012
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