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Individual

CHELSEA RAE DEROCHA-CAVALEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
APNP

Contact information

Practice address
601 N 99TH ST STE 302, WAUWATOSA, WI 53226-4362
(414) 431-2186
(414) 431-9619
Mailing address
2514 S 102ND ST STE 120, WEST ALLIS, WI 53227-2142
(414) 259-8917
(414) 777-5210

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
8293
WI
363L00000X
Nurse Practitioner
Primary
8293-033
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100075795
WI
Enumeration date
03/16/2018
Last updated
05/10/2021
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