Provider Demographics
NPI:1053128587
Name:SAMPSON, ROCHELLE LEE (PRSS-5281)
Entity type:Individual
Prefix:
First Name:ROCHELLE
Middle Name:LEE
Last Name:SAMPSON
Suffix:
Gender:F
Credentials:PRSS-5281
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 E WINNEMUCCA BLVD
Mailing Address - Street 2:
Mailing Address - City:WINNEMUCCA
Mailing Address - State:NV
Mailing Address - Zip Code:89445-2937
Mailing Address - Country:US
Mailing Address - Phone:775-623-1888
Mailing Address - Fax:
Practice Address - Street 1:1200 E WINNEMUCCA BLVD
Practice Address - Street 2:
Practice Address - City:WINNEMUCCA
Practice Address - State:NV
Practice Address - Zip Code:89445-2937
Practice Address - Country:US
Practice Address - Phone:775-623-1888
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-12-17
Last Update Date:2024-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPRSS-5281175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist