Provider Demographics
NPI:1891413415
Name:WARREN, ROCHELLE MARIE (RN MSN)
Entity Type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:MARIE
Last Name:WARREN
Suffix:
Gender:F
Credentials:RN MSN
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:MARIE
Other - Last Name:EVANS/BUNDY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:POST OFFICE BOX 1243
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97520
Mailing Address - Country:US
Mailing Address - Phone:786-762-7320
Mailing Address - Fax:
Practice Address - Street 1:800 LIBERTY ST
Practice Address - Street 2:
Practice Address - City:ASHLAND
Practice Address - State:OR
Practice Address - Zip Code:97520
Practice Address - Country:US
Practice Address - Phone:786-762-7320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-19
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201506083RN163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse