Desiree Nolene Laroche, LPN

Individual provider Active NPI Licensed Practical Nurse · Lower Brule, SD

NPI 1104119700 · NPPES record last updated May 16, 2011

Key facts

NPI
1104119700
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
P010469 (SD)
Practice address
601 Gall St.
Lower Brule, SD 57548
Phone
(605) 473-5526
Fax
(605) 473-5677
NPI assigned
May 16, 2011
Sex
Female
Sole proprietor
No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
0057916OKMDLicensed Practical Nurse
P010469SDMDLicensed Practical Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Lower Brule Health Center IHS Past Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X P010469 SD Yes
Licensed Practical Nurse 164W00000X 0057916 OK

Addresses

Primary practice location

601 Gall St.
Lower Brule, SD 57548

Mailing address

PO Box 248
Lower Brule, SD 57548-0248
Phone (605) 473-5526

Other providers in Lower Brule, SD

All providers in Lower Brule, SD · Licensed Practical Nurse in South Dakota

Sources for this page

Verify at the official NPI Registry.