Provider Demographics
NPI:1992853170
Name:ROCHON, THERESE E (RNP)
Entity Type:Individual
Prefix:MS
First Name:THERESE
Middle Name:E
Last Name:ROCHON
Suffix:
Gender:F
Credentials:RNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 IROQUOIS DR
Mailing Address - Street 2:
Mailing Address - City:WARWICK
Mailing Address - State:RI
Mailing Address - Zip Code:02888-3507
Mailing Address - Country:US
Mailing Address - Phone:401-434-9874
Mailing Address - Fax:
Practice Address - Street 1:51 HEALTH LN
Practice Address - Street 2:
Practice Address - City:WARWICK
Practice Address - State:RI
Practice Address - Zip Code:02886-2710
Practice Address - Country:US
Practice Address - Phone:401-737-6050
Practice Address - Fax:401-737-3084
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-06
Last Update Date:2016-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RINPP37119363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
P15966Medicare UPIN
509022274Medicare ID - Type Unspecified