Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208200000X | Surgeon | 40957 | MN |
Y | 208600000X | Surgeon | 40957 | MN |
N | 2082S0105X | Plastic Hand Surgeon | 40957 | MN |
NPI | 1063499820 |
---|---|
Provider Name | Dr. Heather Lynne Rocheford |
First Address | Maplewood, MN 55119-7175 |
Second Address | Woodbury, MN 55125-2525 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/12/2005 |
Last Update Date | 29/12/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G83031 | (02) |