Physician Compare National (NPI:1255343638)

HEALTHCARE PROVIDER: AMANDA LYNN LAFARLETTE APRNC-NP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1255343638
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	4981613221
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20060505000741
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	LAFARLETTE
	Individual professional last name
Provider First Name	AMANDA
	Individual professional first name
Provider Middle Name	L
	Individual professional middle name
Provider Gender	F
	The provider's gender if the provider is a person.
Provider Credential Text	NP
	The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2005
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	ERICK DEROCHER D O INC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	0547271504
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	3
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	411 N RANDALL AVE
	Group Practice or individual's line 1 address
City	ELK CITY
	Group Practice or individual's city
State	OK
	Group Practice or individual's state
Zip Code	736444127
	Group Practice or individual's zip code (9 digits when available)
Phone Number	5802432273
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	370019
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	GREAT PLAINS REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	370093
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	OU MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 2
Professional Accepts Medicare Assignment	Y