Provider Demographics
NPI:1053780809
Name:ROCHE, SARINA (RN PHD)
Entity type:Individual
Prefix:DR
First Name:SARINA
Middle Name:
Last Name:ROCHE
Suffix:
Gender:F
Credentials:RN PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:303 MONROE HWY
Mailing Address - Street 2:
Mailing Address - City:BROOKS
Mailing Address - State:ME
Mailing Address - Zip Code:04921-3420
Mailing Address - Country:US
Mailing Address - Phone:207-322-9045
Mailing Address - Fax:207-722-3752
Practice Address - Street 1:303 MONROE HWY
Practice Address - Street 2:
Practice Address - City:BROOKS
Practice Address - State:ME
Practice Address - Zip Code:04921-3420
Practice Address - Country:US
Practice Address - Phone:207-322-9045
Practice Address - Fax:207-722-3752
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-23
Last Update Date:2015-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MERN 32549163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME32549OtherRN LICENSE