Provider Demographics
NPI:1164233060
Name:RAUCH, EDWARD ANDREW JR (MSN, APRN)
Entity type:Individual
Prefix:
First Name:EDWARD
Middle Name:ANDREW
Last Name:RAUCH
Suffix:JR
Gender:M
Credentials:MSN, APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2707 AVINITY LN
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22902-6274
Mailing Address - Country:US
Mailing Address - Phone:908-752-3513
Mailing Address - Fax:
Practice Address - Street 1:2707 AVINITY LN
Practice Address - Street 2:
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22902-6274
Practice Address - Country:US
Practice Address - Phone:908-752-3513
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-20
Last Update Date:2025-01-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NR18209600163WC0200X
NJ26NJ15244200364SC0200X, 363LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LC0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCritical Care Medicine
No163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine
No364SC0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistCritical Care Medicine