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NPI Code Detail

MEDICARE: ROCHELLE AUSTIN

MEDICARE: ROCHELLE AUSTIN
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
1164W00000XLicensed Practical NurseL045091-9MN

General Provider Information

NPI Number : 1265574750
Entity Type Code : Individual
Provider Name (Legal Business Name) : ROCHELLE AUSTIN
Provider Business Mailing Address
First Line : 15685 ELDER AVE NW
Second Line :
City : CLEARWATER
State : MN
Zip : 55320-2129
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2800 CLEVELAND AVE N
Second Line :
City : ROSEVILLE
State : MN
Zip : 55113-1126
Country : US
Telephone Number : 651-642-1825
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/13/2007
Last Update Date : 07/08/2007

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Directions to “ ROCHELLE AUSTIN ” Practice Location

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