Provider Demographics
NPI:1366629305
Name:CHERRY, ROCHELLE DENISE (LPN)
Entity Type:Individual
Prefix:MISS
First Name:ROCHELLE
Middle Name:DENISE
Last Name:CHERRY
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:48 PENHURST ST
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14619-1518
Mailing Address - Country:US
Mailing Address - Phone:585-489-0163
Mailing Address - Fax:
Practice Address - Street 1:48 PENHURST ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14619-1518
Practice Address - Country:US
Practice Address - Phone:585-489-0163
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY288446-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse