Provider Demographics
NPI:1871928093
Name:ROCHE, CATHERINE ANN (ARNP)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:ANN
Last Name:ROCHE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5510 UTICA RIDGE RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DAVENPORT
Mailing Address - State:IA
Mailing Address - Zip Code:52807-2946
Mailing Address - Country:US
Mailing Address - Phone:563-424-2025
Mailing Address - Fax:563-424-2042
Practice Address - Street 1:5510 UTICA RIDGE RD
Practice Address - Street 2:SUITE 100
Practice Address - City:DAVENPORT
Practice Address - State:IA
Practice Address - Zip Code:52807-2946
Practice Address - Country:US
Practice Address - Phone:563-424-2025
Practice Address - Fax:563-424-2042
Is Sole Proprietor?:No
Enumeration Date:2013-09-06
Last Update Date:2013-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IAC117430363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics