Individual provider · Type 1 NPI

Shannon Marie Roark, MS, RDN, CLC

Registered Dietitian · Johnson City, TN

NPI number 1174722029 Active

Practice location

185 Treasure Ln
Johnson City, TN 37604-7816

Fax (423) 979-3261

Specialties and licenses

Taxonomy	Code	License
Registered Dietitian Primary	133V00000X	917714 (TN)

Registered Dietitian: A Registered Dietitian (RD)/Registered Dietitian Nutritionist (RDN) is an individual uniquely trained in the science of nutrition and practice of dietetics to design and provide medical nutrition therapy (MNT) and other evidence-based applications of the Nutrition Care Process (NCP) that exemplify the profession's systematic approach to providing high quality nutrition care. Registered dietitians provide MNT for the…

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About NPI 1174722029

Shannon Marie Roark, MS, RDN, CLC's National Provider Identifier is 1174722029, issued on Jul 12, 2007. The primary taxonomy on file is Registered Dietitian (133V00000X), and the practice location is in Johnson City, TN. The record was last updated on Mar 24, 2025.