Provider Demographics
NPI:1043818057
Name:JOCHUMAPRN, LLC
Entity type:Organization
Organization Name:JOCHUMAPRN, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:C
Authorized Official - Last Name:JOCHUM
Authorized Official - Suffix:
Authorized Official - Credentials:APRN
Authorized Official - Phone:772-834-3817
Mailing Address - Street 1:655 N MILITARY TRL STE 7
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33415-1305
Mailing Address - Country:US
Mailing Address - Phone:561-683-4670
Mailing Address - Fax:561-686-8073
Practice Address - Street 1:655 N MILITARY TRL STE 7
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33415-1305
Practice Address - Country:US
Practice Address - Phone:561-683-4670
Practice Address - Fax:561-686-8073
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-12
Last Update Date:2020-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGroup - Single Specialty