Provider Demographics
NPI:1225194426
Name:MACKEY, ROCHELLE BARROWS (RN, MA, APN, AHNC)
Entity type:Individual
Prefix:MS
First Name:ROCHELLE
Middle Name:BARROWS
Last Name:MACKEY
Suffix:
Gender:F
Credentials:RN, MA, APN, AHNC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 HAMILTON RD
Mailing Address - Street 2:
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-1014
Mailing Address - Country:US
Mailing Address - Phone:201-445-3777
Mailing Address - Fax:
Practice Address - Street 1:391 HAMILTON RD
Practice Address - Street 2:
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-1014
Practice Address - Country:US
Practice Address - Phone:201-445-3777
Practice Address - Fax:201-934-8681
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-29
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NC03656800364SM0705X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SM0705XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistMedical-Surgical