Provider Demographics
NPI:1861788325
Name:RAUCH, KATRINA MARIE (CPM, MAP)
Entity type:Individual
Prefix:MRS
First Name:KATRINA
Middle Name:MARIE
Last Name:RAUCH
Suffix:
Gender:F
Credentials:CPM, MAP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15 W WICKS LN
Mailing Address - Street 2:SUITE B
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-3865
Mailing Address - Country:US
Mailing Address - Phone:406-259-9575
Mailing Address - Fax:406-252-4014
Practice Address - Street 1:15 W WICKS LANE
Practice Address - Street 2:SUITE B
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105
Practice Address - Country:US
Practice Address - Phone:406-259-9575
Practice Address - Fax:406-252-4014
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-23
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT48176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife