Provider Demographics
NPI:1942444864
Name:ROCHLEAU, ADRIENNE A (CRNA)
Entity Type:Individual
Prefix:
First Name:ADRIENNE
Middle Name:A
Last Name:ROCHLEAU
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:ADRIENNE
Other - Middle Name:A
Other - Last Name:BIELENBERG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:23867 DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COUNCIL BLUFFS
Mailing Address - State:IA
Mailing Address - Zip Code:51503-7645
Mailing Address - Country:US
Mailing Address - Phone:712-251-2683
Mailing Address - Fax:
Practice Address - Street 1:1400 SENATE AVE
Practice Address - Street 2:
Practice Address - City:RED OAK
Practice Address - State:IA
Practice Address - Zip Code:51566-1271
Practice Address - Country:US
Practice Address - Phone:712-623-7000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-22
Last Update Date:2017-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE101078367500000X
IA123646367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA1942444864OtherNPI