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Individual

CHANNA DELORIS ROCHESTER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
NURSE PRACTITIONER -

Contact information

Practice address
11O8 WAYNE DR, SNELLVILLE, GA 30078
(404) 453-8100
Mailing address
1108 WAYNE DR, SNELLVILLE, GA 30078-2024
(404) 453-8100

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
2023151837
GA
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
RN235085
GA

Other

Enumeration date
03/17/2011
Last updated
03/12/2026
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