Provider Demographics
NPI:1831187673
Name:MARSHALL, ROCHELLE H (FNP)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:H
Last Name:MARSHALL
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:501 LAPEER AVE
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48607-1208
Mailing Address - Country:US
Mailing Address - Phone:989-759-6442
Mailing Address - Fax:989-399-8233
Practice Address - Street 1:1522 JANES AVE
Practice Address - Street 2:
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-1819
Practice Address - Country:US
Practice Address - Phone:989-755-0316
Practice Address - Fax:989-755-0956
Is Sole Proprietor?:No
Enumeration Date:2005-10-06
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704086448363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
1010146OtherHEALTH ADVANTAGE PPO
1010146OtherMCLAREN HEALTH PLAN
MI110OtherCOMMUNITY CHOICE
MI1831187673Medicaid
MI500G310570OtherBCBS
139502OtherGREAT LAKES HEALTH PLAN
500026473OtherRAILROAD MEDICARE
381908328OtherTRICARE
MI4410704OtherMOLINA HEALTH CARE
500026473OtherRAILROAD MEDICARE
MI1831187673Medicaid