Provider Demographics
NPI:1467335901
Name:OCHELLO, JIMMAE JIMQUELLA
Entity type:Individual
Prefix:
First Name:JIMMAE
Middle Name:JIMQUELLA
Last Name:OCHELLO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 RISTROPH ST
Mailing Address - Street 2:
Mailing Address - City:LULING
Mailing Address - State:LA
Mailing Address - Zip Code:70070-4322
Mailing Address - Country:US
Mailing Address - Phone:504-657-3476
Mailing Address - Fax:
Practice Address - Street 1:400 RISTROPH ST
Practice Address - Street 2:
Practice Address - City:LULING
Practice Address - State:LA
Practice Address - Zip Code:70070-4322
Practice Address - Country:US
Practice Address - Phone:504-657-3476
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA207122163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse