Individual
MS. DIANE LYNN ROCHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1500 W ELK AVE, ELIZABETHTON, TN 37643
(423) 543-2584
(423) 722-2060
Mailing address
1500 W ELK AVE, ELIZABETHTON, TN 37643-2654
(423) 543-2584
(423) 722-2060
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
208943
AK
363A00000X
Physician Assistant
Primary
PA3209
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1749627
—
AK
05
—
Q029831
—
TN
Enumeration date
02/15/2017
Last updated
03/04/2026
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