Provider Demographics
NPI:1700896628
Name:LAROCHE, HELENA HILLMAN (MD)
Entity Type:Individual
Prefix:
First Name:HELENA
Middle Name:HILLMAN
Last Name:LAROCHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:HELENA
Other - Middle Name:WINFRED
Other - Last Name:HILLMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:610 E 22ND ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64108-2647
Mailing Address - Country:US
Mailing Address - Phone:816-234-9251
Mailing Address - Fax:
Practice Address - Street 1:610 E 22ND ST
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64108-2647
Practice Address - Country:US
Practice Address - Phone:816-234-9251
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2020-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA36810208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0727610Medicaid
IA26726OtherWELLMARK BCBS
IA26726OtherWELLMARK BCBS
IAI18119Medicare PIN
H97069Medicare UPIN