Provider Demographics
NPI:1336546027
Name:ROCHETTE, RONALD
Entity Type:Individual
Prefix:
First Name:RONALD
Middle Name:
Last Name:ROCHETTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:163 ROUTE 3
Mailing Address - Street 2:APT 13
Mailing Address - City:SOUTH CHINA
Mailing Address - State:ME
Mailing Address - Zip Code:04358-5041
Mailing Address - Country:US
Mailing Address - Phone:207-248-7051
Mailing Address - Fax:
Practice Address - Street 1:163 ROUTE 3
Practice Address - Street 2:APT 13
Practice Address - City:SOUTH CHINA
Practice Address - State:ME
Practice Address - Zip Code:04358-5041
Practice Address - Country:US
Practice Address - Phone:207-248-7051
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-11-25
Last Update Date:2014-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MEPN12929164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse