Provider Demographics
NPI:1508945866
Name:MUSE, ROCHELLE D (PAC)
Entity Type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:D
Last Name:MUSE
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:371 NC HWY 65
Mailing Address - Street 2:SUITE 204
Mailing Address - City:WENTWORTH
Mailing Address - State:NC
Mailing Address - Zip Code:27375
Mailing Address - Country:US
Mailing Address - Phone:336-342-8140
Mailing Address - Fax:336-342-8128
Practice Address - Street 1:371 NC HWY 65
Practice Address - Street 2:SUITE 204
Practice Address - City:WENTWORTH
Practice Address - State:NC
Practice Address - Zip Code:27375
Practice Address - Country:US
Practice Address - Phone:336-342-8140
Practice Address - Fax:336-342-8128
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2024-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC001000657207Q00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC2768306Medicare PIN
NC2768306CMedicare PIN
NCQ77323Medicare UPIN
NC2768306DMedicare PIN