Provider Demographics
NPI:1063302180
Name:ROCHELLE, SARAH RENE
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:RENE
Last Name:ROCHELLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14675 HIGHWAY 194
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:TN
Mailing Address - Zip Code:38060-4133
Mailing Address - Country:US
Mailing Address - Phone:901-290-0428
Mailing Address - Fax:901-290-0723
Practice Address - Street 1:14675 HIGHWAY 194
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:TN
Practice Address - Zip Code:38060-4133
Practice Address - Country:US
Practice Address - Phone:901-290-0428
Practice Address - Fax:901-290-0723
Is Sole Proprietor?:No
Enumeration Date:2025-07-09
Last Update Date:2025-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN81099183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician