Provider Demographics
NPI:1396487526
Name:RAUCHWARG, KAITLYN EMILY (PA-C)
Entity type:Individual
Prefix:
First Name:KAITLYN
Middle Name:EMILY
Last Name:RAUCHWARG
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:6160 KEMPSVILLE CIR STE 200A
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23502-3945
Mailing Address - Country:US
Mailing Address - Phone:757-622-6315
Mailing Address - Fax:757-622-7022
Practice Address - Street 1:207 BULIFANTS BLVD STE C
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23188-5732
Practice Address - Country:US
Practice Address - Phone:757-622-6315
Practice Address - Fax:757-622-7022
Is Sole Proprietor?:No
Enumeration Date:2022-04-08
Last Update Date:2024-06-24
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical