Provider Demographics
NPI:1710503727
Name:DEROCHE, JOY L (NP)
Entity type:Individual
Prefix:
First Name:JOY
Middle Name:L
Last Name:DEROCHE
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JOY
Other - Middle Name:
Other - Last Name:ALDRICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:L
Mailing Address - Street 1:20 ARTISAN DRIVE
Mailing Address - Street 2:SUITE 1150
Mailing Address - City:SALEM
Mailing Address - State:NH
Mailing Address - Zip Code:03079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:123 TURNPIKE ST
Practice Address - Street 2:
Practice Address - City:NORTH ANDOVER
Practice Address - State:MA
Practice Address - Zip Code:01845-5032
Practice Address - Country:US
Practice Address - Phone:781-272-3184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-06-25
Last Update Date:2024-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2299074363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily