Provider Demographics
NPI:1093170367
Name:BRIGITTE ROCHA
Entity Type:Organization
Organization Name:BRIGITTE ROCHA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:201508899LPN
Authorized Official - Prefix:
Authorized Official - First Name:BRIGITTE
Authorized Official - Middle Name:EMILIA
Authorized Official - Last Name:MILLER-ROCHA
Authorized Official - Suffix:
Authorized Official - Credentials:LPN
Authorized Official - Phone:541-228-8682
Mailing Address - Street 1:2841 FRIENDLY ST
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97405-2391
Mailing Address - Country:US
Mailing Address - Phone:541-228-8682
Mailing Address - Fax:
Practice Address - Street 1:2841 FRIENDLY ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97405-2391
Practice Address - Country:US
Practice Address - Phone:541-228-8682
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-12-30
Last Update Date:2015-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes311Z00000XNursing & Custodial Care FacilitiesCustodial Care Facility