Provider Demographics
NPI:1023787975
Name:DEROCHER, TORREY ANN (CNM)
Entity type:Individual
Prefix:
First Name:TORREY
Middle Name:ANN
Last Name:DEROCHER
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4761 BRIARWOOD CT
Mailing Address - Street 2:
Mailing Address - City:AUBURN
Mailing Address - State:MI
Mailing Address - Zip Code:48611-8514
Mailing Address - Country:US
Mailing Address - Phone:989-620-4208
Mailing Address - Fax:
Practice Address - Street 1:3016 W WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6960
Practice Address - Country:US
Practice Address - Phone:989-631-6730
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-13
Last Update Date:2021-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MICNM07333367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife