Provider Demographics
NPI:1811607542
Name:NEPOMUCENO, ROCELYN
Entity type:Individual
Prefix:
First Name:ROCELYN
Middle Name:
Last Name:NEPOMUCENO
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1193 OLD CHARLOTTE TRCE
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37040-2065
Mailing Address - Country:US
Mailing Address - Phone:423-208-8749
Mailing Address - Fax:
Practice Address - Street 1:3056 MILES JOHNSON PKWY
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:TN
Practice Address - Zip Code:37174-4564
Practice Address - Country:US
Practice Address - Phone:877-407-3422
Practice Address - Fax:877-407-4329
Is Sole Proprietor?:No
Enumeration Date:2022-12-05
Last Update Date:2025-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist