Provider Demographics
NPI:1861723025
Name:BROWN, ROCHELLE MARIE (MP)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:MARIE
Last Name:BROWN
Suffix:
Gender:F
Credentials:MP
Other - Prefix:
Other - First Name:ROCHELLE
Other - Middle Name:MARIE
Other - Last Name:O'ROURKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MP
Mailing Address - Street 1:848 3RD ST
Mailing Address - Street 2:
Mailing Address - City:CRESCENT CITY
Mailing Address - State:CA
Mailing Address - Zip Code:95531-4319
Mailing Address - Country:US
Mailing Address - Phone:707-465-1356
Mailing Address - Fax:
Practice Address - Street 1:848 3RD ST
Practice Address - Street 2:
Practice Address - City:CRESCENT CITY
Practice Address - State:CA
Practice Address - Zip Code:95531-4319
Practice Address - Country:US
Practice Address - Phone:707-465-1356
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-01-27
Last Update Date:2010-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA0400551M174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist