Provider Demographics
NPI:1881241305
Name:DESROCHES, LAUREN ELIZABETH (PA)
Entity type:Individual
Prefix:MS
First Name:LAUREN
Middle Name:ELIZABETH
Last Name:DESROCHES
Suffix:
Gender:F
Credentials:PA
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Mailing Address - Street 1:7101 JAHNKE RD # 205
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23225-4017
Mailing Address - Country:US
Mailing Address - Phone:757-716-3742
Mailing Address - Fax:
Practice Address - Street 1:7101 JAHNKE RD # 205
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23225-4017
Practice Address - Country:US
Practice Address - Phone:757-716-3742
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-08-20
Last Update Date:2020-05-05
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant