Provider Demographics
NPI:1568248409
Name:HULETT, ROCHELLE RENEE (AIDE)
Entity Type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:RENEE
Last Name:HULETT
Suffix:
Gender:F
Credentials:AIDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3407 INVERWOOD LANE
Mailing Address - Street 2:INVERWOOD LANE
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20721
Mailing Address - Country:US
Mailing Address - Phone:571-251-5608
Mailing Address - Fax:
Practice Address - Street 1:3407 INVERWOOD LANE
Practice Address - Street 2:INVERWOOD LANE
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20721
Practice Address - Country:US
Practice Address - Phone:571-251-5608
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-06
Last Update Date:2023-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VTG253340374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide