NPI 1871248179

Susan Ann Raque

Practitioner Military Health Care Provider Louisville, KY

Practice location

Address: 1700 Cargo CT, Louisville, KY 40299-1938
Phone: (800) 805-6989

Registered specialties

Military Health Care Provider Primary

Other Service Providers Taxonomy 171000000X Licence 1082389 (KY)

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Registry record

NPI: 1871248179
Entity type: Individual
Sex (as registered): Female
NPI issued: 15 Feb 2022
Record last updated: 15 Feb 2022

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.