Provider Demographics
NPI:1972654721
Name:BROSCH, LAURA RUSE (RN)
Entity Type:Individual
Prefix:MS
First Name:LAURA
Middle Name:RUSE
Last Name:BROSCH
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6159 FIELDCREST DR
Mailing Address - Street 2:
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21701-5810
Mailing Address - Country:US
Mailing Address - Phone:301-620-0818
Mailing Address - Fax:301-620-7289
Practice Address - Street 1:504 SCOTT ST
Practice Address - Street 2:USAMRMC HQ
Practice Address - City:FORT DETRICK
Practice Address - State:MD
Practice Address - Zip Code:21702-9218
Practice Address - Country:US
Practice Address - Phone:301-619-7802
Practice Address - Fax:301-619-7803
Is Sole Proprietor?:No
Enumeration Date:2007-01-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse