Provider Demographics
NPI:1538475959
Name:ROCHA, JENNIFER (RN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:
Last Name:ROCHA
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 1:105 WILLOW AVE
Mailing Address - Street 2:
Mailing Address - City:LITTLE COMPTON
Mailing Address - State:RI
Mailing Address - Zip Code:02837-1539
Mailing Address - Country:US
Mailing Address - Phone:401-439-4305
Mailing Address - Fax:
Practice Address - Street 1:1563 N MAIN ST
Practice Address - Street 2:
Practice Address - City:FALL RIVER
Practice Address - State:MA
Practice Address - Zip Code:02720-2983
Practice Address - Country:US
Practice Address - Phone:508-324-1060
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-08-23
Last Update Date:2010-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2265933163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse