Individual
MS. MARY A ROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN NP
Contact information
Practice address
499 FARMINGTON AVENUE, SUITE 220, FARMINGTON, CT 06032
(860) 678-7300
(860) 677-2693
Mailing address
499 FARMINGTON AVENUE, SUITE 220, FARMINGTON, CT 06032
(860) 678-7300
(860) 677-2693
Taxonomy
Speciality
Code
Description
License number
State
363LW0102X
Women's Health Nurse Practitioner
Primary
001332
CT
364SW0102X
Women's Health Clinical Nurse Specialist
001332
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004226850
—
CT
Enumeration date
09/28/2006
Last updated
01/11/2010
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