Basic Information
Provider Information
NPI: 1699777425
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: RAJOTTE
FirstName: CHERYL
MiddleName: A
NamePrefix: MRS.
NameSuffix:  
Credential: ARNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3011 N MICHIGAN ST
Address2:  
City: PITTSBURG
State: KS
PostalCode: 667622546
CountryCode: US
TelephoneNumber: 6202319873
FaxNumber: 6202312808
Practice Location
Address1: 3011 N MICHIGAN ST
Address2:  
City: PITTSBURG
State: KS
PostalCode: 667622546
CountryCode: US
TelephoneNumber: 6202319873
FaxNumber: 6202312808
Other Information
ProviderEnumerationDate: 08/11/2005
LastUpdateDate: 02/08/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LC1500X44933KSY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerCommunity Health

No ID Information.


Home