Provider Demographics
NPI:1639455926
Name:ROCHE, LAURA (NP-C)
Entity Type:Individual
Prefix:
First Name:LAURA
Middle Name:
Last Name:ROCHE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2204 WHITESBURG DR SW STE 300
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35801-4523
Mailing Address - Country:US
Mailing Address - Phone:281-725-2637
Mailing Address - Fax:866-717-6708
Practice Address - Street 1:2204 WHITESBURG DR SW STE 300
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35801-4523
Practice Address - Country:US
Practice Address - Phone:281-725-2637
Practice Address - Fax:866-717-6708
Is Sole Proprietor?:No
Enumeration Date:2011-10-31
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX770026363LF0000X
AL1-114749363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
1639455926OtherNPI