| NPI | 1033243209 |
|---|---|
| Former Name | MICHELLE LYNN ROARK |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: SC 21514) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: IN 71002798A) |
| 363LF0000X Nurse Practitioner, Family (Licence: FL ARNP 9371635) | |
| 363LF0000X Nurse Practitioner, Family (Licence: IL 209-001576) | |
| Enumeration Date | 2007-03-16 |
| Last Update Date | 2022-07-12 |