Provider Demographics
NPI:1407236599
Name:ROACH, ALESHA N (MD)
Entity Type:Individual
Prefix:DR
First Name:ALESHA
Middle Name:N
Last Name:ROACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALESHA
Other - Middle Name:N
Other - Last Name:PRIOR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:14001 RIDGEDALE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:MINNETONKA
Mailing Address - State:MN
Mailing Address - Zip Code:55305-1747
Mailing Address - Country:US
Mailing Address - Phone:952-249-2000
Mailing Address - Fax:
Practice Address - Street 1:14001 RIDGEDALE DR STE 200
Practice Address - Street 2:
Practice Address - City:MINNETONKA
Practice Address - State:MN
Practice Address - Zip Code:55305-1747
Practice Address - Country:US
Practice Address - Phone:952-249-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2021-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN66191207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology