Renay Lee Desrocher, REGISTERED NURSE

Primary specialty

Pediatric Registered NurseTaxonomy code 163WP0200X

License

22379141 Issued in NY

Practice address

412 Stratton Hill Rd
West Chazy, NY 12992-3630

Phone

(518) 493-4134

NPI assigned

Apr 17, 2008

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1208390400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1208390400000",
    "number": "1720252919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 STRATTON HILL RD",
            "city": "WEST CHAZY",
            "state": "NY",
            "postal_code": "129923630",
            "telephone_number": "518-493-4134"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 STRATTON HILL RD",
            "city": "WEST CHAZY",
            "state": "NY",
            "postal_code": "129923630",
            "telephone_number": "518-493-4134"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DESROCHER",
        "first_name": "RENAY",
        "middle_name": "LEE",
        "name_prefix": "Ms.",
        "credential": "REGISTERED NURSE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-04-17",
        "last_updated": "2008-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Pediatrics",
            "state": "NY",
            "license": "22379141",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02923393",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rachael Christiana, M.A. CCC - SLP
• Scott Alan Coleman, RN, MS, AE-C
• Melinda Joan Conroy, OTR
• Audrey Crucetti
• Michaela Davison, RN
• Sherry Ann Deyo-Pugh, REGISTERED NURSE
• Jo Dragoon-Morse, R.D.
• Gina Joann Faoro Gratton, PT
• Laura Flax
• Lucy Anne Giroux, CCC-SLP

• Pediatric Registered Nurse in West Chazy, NY
• Providers in West Chazy, NY by specialty
• Pediatric Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 17, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.