Provider Demographics
NPI:1598141103
Name:RICHBART, ROCHELLE ANNETTE (RN)
Entity Type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:ANNETTE
Last Name:RICHBART
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 1:52 SULLIVAN ST
Mailing Address - Street 2:#3
Mailing Address - City:CHARLESTOWN
Mailing Address - State:MA
Mailing Address - Zip Code:02129-2444
Mailing Address - Country:US
Mailing Address - Phone:857-310-0457
Mailing Address - Fax:
Practice Address - Street 1:52 SULLIVAN ST
Practice Address - Street 2:#3
Practice Address - City:CHARLESTOWN
Practice Address - State:MA
Practice Address - Zip Code:02129-2444
Practice Address - Country:US
Practice Address - Phone:857-310-0457
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-05
Last Update Date:2015-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2276990163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse