Provider Demographics
NPI:1699407874
Name:ROCHE, MARIA
Entity Type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:ROCHE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4207 S 51ST ST APT 5
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53220-3230
Mailing Address - Country:US
Mailing Address - Phone:414-708-7833
Mailing Address - Fax:
Practice Address - Street 1:4465 S 48TH ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:WI
Practice Address - Zip Code:53220-3618
Practice Address - Country:US
Practice Address - Phone:414-750-7645
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-27
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion