Roach, Jenna
Roach, Jenna is an sole proprietor health care provider with primary practice located at 2000 Tybee Ln , Lake Charles LA 70605-4171. She recently has only one registered license in Allopathic & Osteopathic Physicians / Dermatology, which is considered as her primary health care specialty. Roach, Jenna can be contacted via phone (337) 433-7272.Contact Information
Primary practice address
2000 Tybee Ln
Lake Charles LA 70605-4171
Phone: (337) 433-7272
Fax: (337) 433-0730
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Dermatology | 207N00000X | 321797 | Louisiana |
Profile Details
| NPI number | 1326401183 |
|---|---|
| LBN Legal business name | Roach, Jenna |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Mar 30th, 2016 |
| Last updated | Jan 30th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326401183 | NPPES |
| Louisiana | Other | 321797 | STATE MEDICAL LICENSE |
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