Provider Demographics
NPI:1972370278
Name:BACULIO, NOEMIE ROCALES (RN)
Entity Type:Individual
Prefix:MS
First Name:NOEMIE
Middle Name:ROCALES
Last Name:BACULIO
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:PO BOX 11
Mailing Address - Street 2:
Mailing Address - City:PHILIP
Mailing Address - State:SD
Mailing Address - Zip Code:57567-0011
Mailing Address - Country:US
Mailing Address - Phone:605-441-1211
Mailing Address - Fax:
Practice Address - Street 1:HANS PETERSON MEMORIAL HOSPITAL
Practice Address - Street 2:503 WEST PINE ST.
Practice Address - City:PHILIP
Practice Address - State:SD
Practice Address - Zip Code:57567
Practice Address - Country:US
Practice Address - Phone:605-859-2511
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-06
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDR054936163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergencyGroup - Single Specialty