Provider Demographics
NPI:1205109816
Name:ROCHELLE, PAULA (ND)
Entity type:Individual
Prefix:MS
First Name:PAULA
Middle Name:
Last Name:ROCHELLE
Suffix:
Gender:F
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 6856
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-6856
Mailing Address - Country:US
Mailing Address - Phone:918-786-3686
Mailing Address - Fax:918-786-3726
Practice Address - Street 1:63225 E 290 RD
Practice Address - Street 2:
Practice Address - City:GROVE
Practice Address - State:OK
Practice Address - Zip Code:74344-7552
Practice Address - Country:US
Practice Address - Phone:918-786-3686
Practice Address - Fax:918-786-3726
Is Sole Proprietor?:Yes
Enumeration Date:2012-02-13
Last Update Date:2012-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKRND2000449175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath