Provider Demographics
NPI:1275851966
Name:HYCHE, ROSALIND JO ANN
Entity Type:Individual
Prefix:MRS
First Name:ROSALIND
Middle Name:JO ANN
Last Name:HYCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:372 S INDEPENDENCE BLVD
Mailing Address - Street 2:SUITE 109
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-1000
Mailing Address - Country:US
Mailing Address - Phone:757-513-1875
Mailing Address - Fax:
Practice Address - Street 1:372 S INDEPENDENCE BLVD
Practice Address - Street 2:SUITE 109
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23452-1000
Practice Address - Country:US
Practice Address - Phone:757-513-1875
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-05
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1201078887174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist