Provider Demographics
NPI:1407404221
Name:RAYMOND, ROCHELLE (DNP, RN PMHNP-BC)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:
Last Name:RAYMOND
Suffix:
Gender:F
Credentials:DNP, RN PMHNP-BC
Other - Prefix:DR
Other - First Name:ROCHELLE
Other - Middle Name:K
Other - Last Name:RAYMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DNP, RN PMHNP-BC
Mailing Address - Street 1:1375 R DALE WERTZ DR
Mailing Address - Street 2:
Mailing Address - City:BAD AXE
Mailing Address - State:MI
Mailing Address - Zip Code:48413-1365
Mailing Address - Country:US
Mailing Address - Phone:989-269-9293
Mailing Address - Fax:989-269-7544
Practice Address - Street 1:1375 R DALE WERTZ DR
Practice Address - Street 2:
Practice Address - City:BAD AXE
Practice Address - State:MI
Practice Address - Zip Code:48413-1365
Practice Address - Country:US
Practice Address - Phone:989-269-9293
Practice Address - Fax:989-269-9754
Is Sole Proprietor?:No
Enumeration Date:2019-08-27
Last Update Date:2020-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704266109363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health