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Shelly Gunnell Roark, NURSEPRACTITIONER
Women's Health Nurse Practitioner in Laurel, Mississippi
NPI 1083170559

Shelly Gunnell Roark is a Women's Health Nurse Practitioner based in Laurel, MS and is specialized in Women's Health. Shelly Gunnell Roark practices in Laurel, MS and has the professional credentials of NURSEPRACTITIONER. The NPI Number for Shelly Gunnell Roark is 1083170559 and holds a License No. 902947 (Mississippi).

The current practice location address for Shelly Gunnell Roark is 103 S 12Th Ave, Laurel, MS and can be reached out via phone at 601-399-1970. You can also correspond with Shelly Gunnell Roark through the mailing address at 117 S 11TH AVE, LAUREL, MS - 39440-4312 (mailing address contact number: 601-425-3033).

Location: 103 S 12Th Ave, Laurel, MS, 39440-4312
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Provider Profile Details
NPI Number
1083170559
Provider Name
Shelly Gunnell Roark
Credential
NURSEPRACTITIONER
Provider Entity Type
Individual
Gender
Female
Address
103 S 12Th Ave, Laurel, MS, 39440-4312
Phone Number
601-399-1970
Fax Number
Provider Enumeration Date
02/20/2019
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
PENDING 05 MS
institution
Provider Business Practice Location Address Details
Address
103 S 12Th Ave
City
State
Zip
39440-4322
Phone Number
601-399-1970
Fax Number
person
Provider Business Mailing Address Details
Address
103 S 12Th Ave
City
State
Zip
39440-4322
Phone Number
601-399-1970
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Community Health
Taxonomy
License No.
902947 (Mississippi)
Definition
Definition to come...
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Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Women's Health
Taxonomy
License No.
902947 (Mississippi)
Definition
Definition to come...
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