Provider Demographics
NPI:1255476735
Name:ROCHE, CONSTANCE ANNE (RN, NP)
Entity type:Individual
Prefix:MS
First Name:CONSTANCE
Middle Name:ANNE
Last Name:ROCHE
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Gender:F
Credentials:RN, NP
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Mailing Address - Street 1:17 BELKNAP ST
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:MA
Mailing Address - Zip Code:01742-2401
Mailing Address - Country:US
Mailing Address - Phone:617-726-9200
Mailing Address - Fax:617-726-9210
Practice Address - Street 1:55 FRUIT ST
Practice Address - Street 2:WANG SUITE 240
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2621
Practice Address - Country:US
Practice Address - Phone:617-726-9200
Practice Address - Fax:617-726-9210
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2012-01-25
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Provider Licenses
StateLicense IDTaxonomies
MA115238163WX0200X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163WX0200XNursing Service ProvidersRegistered NurseOncology