Provider Demographics
NPI:1629950357
Name:LAURA J. BACH PLLC
Entity type:Organization
Organization Name:LAURA J. BACH PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PROVIDER
Authorized Official - Prefix:MS
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:BACH
Authorized Official - Suffix:
Authorized Official - Credentials:PMHNP-BC
Authorized Official - Phone:984-215-0992
Mailing Address - Street 1:5607 NC HWY 55
Mailing Address - Street 2:SUITE 203
Mailing Address - City:DURHAM
Mailing Address - State:NC
Mailing Address - Zip Code:27713-4394
Mailing Address - Country:US
Mailing Address - Phone:984-215-0992
Mailing Address - Fax:855-271-8304
Practice Address - Street 1:5607 NC HWY 55
Practice Address - Street 2:SUITE 203
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27713-4394
Practice Address - Country:US
Practice Address - Phone:984-215-0992
Practice Address - Fax:855-271-8304
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-23
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty