Provider Demographics
NPI:1275873929
Name:LAROCHE, JAMIE L (APRN)
Entity Type:Individual
Prefix:MRS
First Name:JAMIE
Middle Name:L
Last Name:LAROCHE
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:MISS
Other - First Name:JAMIE
Other - Middle Name:LEE
Other - Last Name:HANEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 678
Mailing Address - Street 2:
Mailing Address - City:LACONIA
Mailing Address - State:NH
Mailing Address - Zip Code:03247-0678
Mailing Address - Country:US
Mailing Address - Phone:603-524-3211
Mailing Address - Fax:603-527-7164
Practice Address - Street 1:80 HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:LACONIA
Practice Address - State:NH
Practice Address - Zip Code:03246-3235
Practice Address - Country:US
Practice Address - Phone:603-527-2819
Practice Address - Fax:603-527-2984
Is Sole Proprietor?:No
Enumeration Date:2013-02-18
Last Update Date:2013-03-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH051916-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily