Healthcare Provider Details

I. General information

NPI: 1316841372
Provider Name (Legal Business Name): LAURA ROETH RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2026
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2730 ALTON DARBY CREEK RD
HILLIARD OH
43026-9770
US

IV. Provider business mailing address

2730 ALTON DARBY CREEK RD
HILLIARD OH
43026-9770
US

V. Phone/Fax

Practice location:
  • Phone: 614-921-5050
  • Fax:
Mailing address:
  • Phone: 614-921-5050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WS0200X
TaxonomySchool Registered Nurse
License NumberRN.319174
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: