Connie Sue Rackow, CNP

Primary specialty

Women's Health Nurse PractitionerTaxonomy code 363LW0102X

License

NP02547 Issued in OH

Practice address

334 E Milltown Rd
Wooster, OH 44691

Phone

(330) 345-7798

Fax

(330) 345-7225

NPI assigned

Oct 20, 2005

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1129766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1411603200000",
    "number": "1043209281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "334 E MILLTOWN RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "44691",
            "telephone_number": "330-345-7798",
            "fax_number": "330-345-7225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "334 E MILLTOWN RD",
            "city": "WOOSTER",
            "state": "OH",
            "postal_code": "44691",
            "telephone_number": "330-345-7798",
            "fax_number": "330-345-7225"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RACKOW",
        "first_name": "CONNIE",
        "middle_name": "SUE",
        "credential": "CNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-20",
        "last_updated": "2014-09-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "OH",
            "license": "NP02547",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OH",
            "license": "RN137212",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2450637",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Women's Health Nurse Practitioner in Wooster, OH
• Providers in Wooster, OH by specialty
• Women's Health Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.