Provider Demographics
NPI:1942620273
Name:DAVIS, ROCHELLE NICOLE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:NICOLE
Last Name:DAVIS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 W 86TH ST
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-2101
Mailing Address - Country:US
Mailing Address - Phone:866-389-2727
Mailing Address - Fax:317-972-1190
Practice Address - Street 1:1375 W 86TH ST
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2101
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:317-972-1190
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-25
Last Update Date:2022-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71004679A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily