MEDICARE: TAMARA ROCHESTER

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	APRN.CNP.0041772	OH
2	163W00000X	Registered Nurse	RN.384187	OH

General Provider Information

NPI Number	:	1104339837
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TAMARA ROCHESTER

Provider Business Mailing Address
First Line	:	5474 YELLOWSTONE DR
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014-3869
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	5474 YELLOWSTONE DR
Second Line	:
City	:	FAIRFIELD
State	:	OH
Zip	:	45014
Country	:	US
Telephone Number	:	567-712-4026
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/16/2017
Last Update Date	:	03/25/2026

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Directions to “ TAMARA ROCHESTER ” Practice Location

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