MEDICARE: ROCHELLE MARIE BROWN MP

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	174400000X	Specialist	0400551M	CA

General Provider Information

NPI Number	:	1861723025
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROCHELLE MARIE BROWN MP

Provider Business Mailing Address
First Line	:	848 3RD ST
Second Line	:
City	:	CRESCENT CITY
State	:	CA
Zip	:	95531-4319
Country	:	US
Telephone Number	:	707-465-1356
Fax Number	:

Provider Business Practice Location Address
First Line	:	848 3RD ST
Second Line	:
City	:	CRESCENT CITY
State	:	CA
Zip	:	95531-4319
Country	:	US
Telephone Number	:	707-465-1356
Fax Number	:

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

Provider Enumeration Date	:	01/27/2010
Last Update Date	:	01/27/2010

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Directions to “ ROCHELLE MARIE BROWN MP” Practice Location

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