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Individual

DR. BENJAMIN RAWALT

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DNP

Contact information

Practice address
325 MAINE ST, LAWRENCE, KS 66044-1360
(785) 505-3350
(785) 505-2874
Mailing address
2114 N 1000TH RD, EUDORA, KS 66025-9193

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
141628
KS
363LA2100X
Acute Care Nurse Practitioner
Primary
78860
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
30004643160001
KS
Enumeration date
05/20/2019
Last updated
10/26/2023
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