| Laura G Roque, CRNP | |
|
10260 Silverside St Ste 100, Ijamsville, MD 21754-9174 | |
| (301) 682-4100 | |
| (301) 682-9100 |
| Full Name | Laura G Roque |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 8 Years |
| Location | 10260 Silverside St Ste 100, Ijamsville, Maryland |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720581887 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363LF0000X | Nurse Practitioner - Family | R209409 (Maryland) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Frederick Health Hospital | Frederick, MD | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Privia Care Center Llc | 3274801139 | 251 |
| Amber Hill Physical Therapy Inc | 8527963917 | 227 |
| Entity Name | Privia Medical Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1013042480 PECOS PAC ID: 4385682061 Enrollment ID: O20140522000040 |
| Entity Name | Privia Care Center Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1164874426 PECOS PAC ID: 3274801139 Enrollment ID: O20170619000055 |
| Mailing Address | Practice Location Address |
|---|---|
| Laura G Roque, CRNP 610 Solarex Ct, Frederick, MD 21703-8624 Ph: (301) 663-6162 | Laura G Roque, CRNP 10260 Silverside St Ste 100, Ijamsville, MD 21754-9174 Ph: (301) 682-4100 |
Jody Lynn Cochran, CRNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 10260 Silverside St Ste 100, Ijamsville, MD 21754 Phone: 301-682-4100 Fax: 301-682-9100 | |
Mrs. Susan Kay Vonk, APRN, FNP-BC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 11290 Woodhaven Dr, Ijamsville, MD 21754 Phone: 919-457-2323 |