Individual
ROCHELLE ADDISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
205 E 3RD ST, JOHNSTON CITY, IL 62951-1624
(314) 461-7061
Mailing address
131 AUGUST PL, FLORISSANT, MO 63034-2873
(314) 461-7061
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
043134847
IL
Other
Enumeration date
04/23/2025
Last updated
04/24/2025
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