Provider Demographics
NPI:1770227142
Name:LAROCHELLE, NICOLE L (RN)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:L
Last Name:LAROCHELLE
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 1:2022 CEDAR BROOK DR
Mailing Address - Street 2:
Mailing Address - City:HERMON
Mailing Address - State:ME
Mailing Address - Zip Code:04401-1325
Mailing Address - Country:US
Mailing Address - Phone:207-852-7059
Mailing Address - Fax:
Practice Address - Street 1:2022 CEDAR BROOK DR
Practice Address - Street 2:
Practice Address - City:HERMON
Practice Address - State:ME
Practice Address - Zip Code:04401-1325
Practice Address - Country:US
Practice Address - Phone:207-852-7059
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-22
Last Update Date:2022-04-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN56632163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WH0200XNursing Service ProvidersRegistered NurseHome HealthGroup - Single Specialty