Provider Demographics
NPI:1407235849
Name:BIG HAIR, ANDREA ROCHELLE (RN)
Entity Type:Individual
Prefix:
First Name:ANDREA
Middle Name:ROCHELLE
Last Name:BIG HAIR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 LAPIN ST
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-1868
Mailing Address - Country:US
Mailing Address - Phone:406-208-4055
Mailing Address - Fax:
Practice Address - Street 1:10110 SOUTH 7650 EAST
Practice Address - Street 2:BOX9
Practice Address - City:CROW AGENCY
Practice Address - State:MT
Practice Address - Zip Code:59022-0009
Practice Address - Country:US
Practice Address - Phone:406-638-3361
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-05-19
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTRN-70247163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse