Individual provider · Type 1 NPI
Shelly Gunnell Roark, NURSE PRACTITIONER
Women's Health Nurse Practitioner · Hattiesburg, MS
NPI number
1083170559
Active
Practice location
5003 Hardy St Ste 350
Hattiesburg, MS 39402-1323
Fax (601) 268-9559
Mailing address
6524 U S Highway 98
Hattiesburg, MS 39402-8569
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Community Health Nurse Practitioner | 363LC1500X | 902947 (MS) |
| Women's Health Nurse Practitioner Primary | 363LW0102X | 902947 (MS) |
Women's Health Nurse Practitioner: Definition to come...
Other women's health nurse practitioner providers in Hattiesburg
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About NPI 1083170559
Shelly Gunnell Roark, NURSE PRACTITIONER's National Provider Identifier is 1083170559, issued on Feb 20, 2019. The primary taxonomy on file is Women's Health Nurse Practitioner (363LW0102X), and the practice location is in Hattiesburg, MS. The record was last updated on Feb 24, 2025.