Individual
DESIREE NOLENE LAROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
601 GALL ST., LOWER BRULE, SD 57548
(605) 473-5526
(605) 473-5677
Mailing address
PO BOX 248, LOWER BRULE, SD 57548-0248
(605) 473-5526
(605) 473-5677
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
0057916
OK
164W00000X
Licensed Practical Nurse
Primary
P010469
SD
Other
Enumeration date
05/16/2011
Last updated
05/16/2011
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