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NPI Code Detail

MEDICARE: LACEY JOY ROEHL

MEDICARE: LACEY JOY ROEHL
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163W00000XRegistered NurseR41358ND

General Provider Information

NPI Number : 1568391167
Entity Type Code : Individual
Provider Name (Legal Business Name) : LACEY JOY ROEHL
Provider Business Mailing Address
First Line : 1010 7TH AVE NE
Second Line :
City : PERHAM
State : MN
Zip : 56573-2358
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2101 ELM ST N
Second Line :
City : FARGO
State : ND
Zip : 58102-2417
Country : US
Telephone Number : 701-232-3241
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/18/2026
Last Update Date : 05/18/2026

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Directions to “ LACEY JOY ROEHL ” Practice Location

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