Provider Demographics
NPI:1265191274
Name:BURTON, ROCHELLE (RN)
Entity type:Individual
Prefix:MRS
First Name:ROCHELLE
Middle Name:
Last Name:BURTON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4699 SAHALEE DR
Mailing Address - Street 2:
Mailing Address - City:GROVE CITY
Mailing Address - State:OH
Mailing Address - Zip Code:43123-8179
Mailing Address - Country:US
Mailing Address - Phone:614-332-2392
Mailing Address - Fax:
Practice Address - Street 1:4699 SAHALEE DR
Practice Address - Street 2:
Practice Address - City:GROVE CITY
Practice Address - State:OH
Practice Address - Zip Code:43123-8179
Practice Address - Country:US
Practice Address - Phone:614-332-2392
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-17
Last Update Date:2021-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH368312163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN.368312OtherNURSING LICENSE