Healthcare Provider Details

I. General information

NPI: 1609707074
Provider Name (Legal Business Name): ROCHELLE HUMPHREYS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/26/2026
Last Update Date: 05/26/2026
Certification Date: 05/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

75433 CRESTVIEW HILLS LOOP
COVINGTON LA
70435-5685
US

IV. Provider business mailing address

75433 CRESTVILLE HILLS LOOP
COVINGTON LA
70435
US

V. Phone/Fax

Practice location:
  • Phone: 504-430-0964
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number110729
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: