Provider Demographics
NPI:1144701806
Name:HARTWICH, RACHAEL ROSENBAUM (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:MRS
First Name:RACHAEL
Middle Name:ROSENBAUM
Last Name:HARTWICH
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:MRS
Other - First Name:RACHAEL
Other - Middle Name:
Other - Last Name:ROSENBAUM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4831 W 136TH ST UNIT A
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66224-5924
Mailing Address - Country:US
Mailing Address - Phone:913-498-8787
Mailing Address - Fax:
Practice Address - Street 1:4831 W 136TH ST UNIT A
Practice Address - Street 2:
Practice Address - City:OVERLAND PARK
Practice Address - State:KS
Practice Address - Zip Code:66224-5924
Practice Address - Country:US
Practice Address - Phone:913-498-8787
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-21
Last Update Date:2019-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS78257363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner