Provider Demographics
NPI:1275047896
Name:ROCHA, LAUREN (DNP, CPNP-PC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:
Last Name:ROCHA
Suffix:
Gender:F
Credentials:DNP, CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1808 TRADEWINDS BLVD APT L203
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:TX
Mailing Address - Zip Code:79706-3128
Mailing Address - Country:US
Mailing Address - Phone:562-665-2308
Mailing Address - Fax:
Practice Address - Street 1:4214 MAMIES CIR
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:TX
Practice Address - Zip Code:79707-2123
Practice Address - Country:US
Practice Address - Phone:432-620-8687
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-17
Last Update Date:2017-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP134932363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics