Rayann Nowacki
Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Lake Station, IN
NPI 1629930599 · NPPES record last updated Dec 1, 2025
Key facts
- NPI
- 1629930599
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Student in an Organized Health Care Education/Training Program 390200000X
- Practice address
- 4835 E 25TH Ave
Lake Station, IN 46405-2623 - Phone
- (219) 840-8665
- NPI assigned
- Dec 1, 2025
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | |||
| Student in an Organized Health Care Education/Training Program | 390200000X | IN | Yes |
Addresses
Primary practice location
4835 E 25TH Ave
Lake Station, IN 46405-2623
Mailing address
4835 E 25TH Ave
Lake Station, IN 46405-2623
Phone (219) 840-8665
Other providers in Lake Station, IN
- Northshore Health Centers
- Northshore Health Centers, Inc.
- Northshore Health Centers, Inc.
- Northshore Health Centers, Inc.
- Northshore Health Centers, Inc.
- Peggy Ruth Payonk
- Kari Payton
- Keith Minton Ramsey
- Reliable Denture Center
- Kathryn Elizabeth Ritchie
All providers in Lake Station, IN · Student in an Organized Health Care Education/Training Program in Indiana
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.