Healthcare Provider Details

I. General information

NPI: 1437263720
Provider Name (Legal Business Name): LAURA BACH PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/17/2006
Last Update Date: 09/24/2025
Certification Date: 09/24/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5607 NC HIGHWAY 55 STE 203
DURHAM NC
27713-4394
US

IV. Provider business mailing address

5607 NC HIGHWAY 55 STE 203
DURHAM NC
27713-4394
US

V. Phone/Fax

Practice location:
  • Phone: 984-215-0992
  • Fax: 855-271-8304
Mailing address:
  • Phone: 984-215-0992
  • Fax: 855-271-8304

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number201365
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License Number158521
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: