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Susan Ann Raque
Military Health Care Provider in Louisville, Kentucky
NPI 1871248179

Susan Ann Raque is a Military Health Care Provider based in Louisville, KY. Susan Ann Raque practices in Louisville, KY. The NPI Number for Susan Ann Raque is 1871248179 and holds a License No. 1082389 (Kentucky).

The current practice location address for Susan Ann Raque is 1700 Cargo Ct, Louisville, KY and can be reached out via phone at 800-805-6989.

Location: 1700 Cargo Ct, Louisville, KY, 40299-1938
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1871248179
Provider Name
Susan Ann Raque
Credential
Provider Entity Type
Individual
Gender
Female
Address
1700 Cargo Ct, Louisville, KY, 40299-1938
Phone Number
800-805-6989
Fax Number
Provider Enumeration Date
02/15/2022
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1700 Cargo Ct
City
Louisville
State
Kentucky
Zip
40299-1938
Phone Number
800-805-6989
Fax Number
person
Provider Business Mailing Address Details
Address
1700 Cargo Ct
City
Louisville
State
Kentucky
Zip
40299-1938
Phone Number
800-805-6989
Fax Number
person
Provider's Taxonomy Details 1
Type
Other Service Providers
Classification
Military Health Care Provider
Speciality
-
Taxonomy
171000000X
License No.
1082389 (Kentucky)
Definition
Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes.
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