| Provider / Organization | NPI | Date Certified |
|---|---|---|
| JESSICA WALTRIP ROCHA | 1023606522 | 2021-01-10 |
| Entity Type | Individual |
| Provider Name | Jessica Waltrip Rocha APRN |
| Practice Office Address | 497 SADLER WAY FRANKLIN, TN US |
| Practice Office Telephone | 6153949727 |
| Mailing Address | 497 SADLER WAY FRANKLIN, TN 370694320 US |
| Business Telephone | 6153949727 |
| Code | License No | State |
|---|---|---|
| 363L00000X PRIMARY | F10200671 | TN |
| 193400000X SING | Group Code |
| F10200671 | MEDICAID | TN |