Provider Demographics
NPI:1497162663
Name:FIELDER, ROCHELLE (LPN)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:FIELDER
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 1:27603 N 205TH AVE
Mailing Address - Street 2:
Mailing Address - City:WITTMANN
Mailing Address - State:AZ
Mailing Address - Zip Code:85361-9757
Mailing Address - Country:US
Mailing Address - Phone:303-881-3033
Mailing Address - Fax:
Practice Address - Street 1:27603 N 205TH AVE
Practice Address - Street 2:
Practice Address - City:WITTMANN
Practice Address - State:AZ
Practice Address - Zip Code:85361-9757
Practice Address - Country:US
Practice Address - Phone:303-881-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-18
Last Update Date:2014-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO43678164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse