Healthcare Provider Details

I. General information

NPI: 1306905856
Provider Name (Legal Business Name): BARBARA A ROCHA RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HOPPIN ST
PROVIDENCE RI
02903-4141
US

IV. Provider business mailing address

1 HOPPIN ST
PROVIDENCE RI
02903-4141
US

V. Phone/Fax

Practice location:
  • Phone: 401-444-8850
  • Fax:
Mailing address:
  • Phone: 401-444-8850
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number20557
License Number StateRI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: