Provider Demographics
NPI:1194968966
Name:MASON, ROCHELLE DANIELLE (LPN)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:DANIELLE
Last Name:MASON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3668 SOFT WIND DR
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43232-6523
Mailing Address - Country:US
Mailing Address - Phone:614-429-9917
Mailing Address - Fax:
Practice Address - Street 1:3668 SOFT WIND DR
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43232-6523
Practice Address - Country:US
Practice Address - Phone:614-429-9917
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-09
Last Update Date:2009-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 127460164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse