person
Leasa L Roach, GNP
Gerontology Nurse Practitioner in Texarkana, Arkansas
NPI 1326061235

Leasa L Roach is a Gerontology Nurse Practitioner based in Texarkana, AR and is specialized in Gerontology. Leasa L Roach practices in Texarkana, AR and has the professional credentials of GNP. The NPI Number for Leasa L Roach is 1326061235 and holds a License No. 526631 (Arkansas).

The current practice location address for Leasa L Roach is 1205 E 35Th St, Texarkana, AR and can be reached out via phone at 903-735-5355 and via fax at 903-735-5399. You can also correspond with Leasa L Roach through the mailing address at 1205 E 35TH ST, TEXARKANA, AR - 71854-2746 (mailing address contact number: 903-835-5355).

Location: 1205 E 35Th St, Texarkana, AR, 71854-2746
person
Provider Profile Details
NPI Number
1326061235
Provider Name
Leasa L Roach
Credential
GNP
Provider Entity Type
Individual
Gender
Female
Address
1205 E 35Th St, Texarkana, AR, 71854-2746
Phone Number
903-735-5355
Fax Number
903-735-5399
Provider Enumeration Date
07/25/2006
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
526631 01 TX LICENSE
163821758 05 AR
8Y1726 01 TX BLUE CROSS BLUE SHIELD
5A158 01 AR BLUECROSS BLUESHIELD
P00376988 01 TX RAILROAD MEDICARE
institution
Provider Business Practice Location Address Details
Address
1205 E 35Th St
City
State
Zip
71854-2746
Phone Number
903-735-5355
Fax Number
903-735-5399
person
Provider Business Mailing Address Details
Address
1205 E 35Th St
City
State
Zip
71854-2746
Phone Number
903-735-5355
Fax Number
903-735-5399
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Gerontology
Taxonomy
License No.
526631 (Texas)
Definition
Definition to come...
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