person
Mrs. Bertha Ann Roark, RN
School Registered Nurse in Bloomfield, New Mexico
NPI 1750598835

Bertha Ann Roark is a School Registered Nurse based in Bloomfield, NM and is specialized in School. Bertha Ann Roark practices in Bloomfield, NM and has the professional credentials of RN. The NPI Number for Bertha Ann Roark is 1750598835 and holds a License No. R18502 (New Mexico).

The current practice location address for Bertha Ann Roark is 310 La Jara St, Bloomfield, NM and can be reached out via phone at 505-634-3673 and via fax at 505-634-3675. You can also correspond with Bertha Ann Roark through the mailing address at 712 N 3RD ST., BLOOMFIELD, NM - 87413 (mailing address contact number: 505-634-3673).

Location: 310 La Jara St, Bloomfield, NM, 87413
person
Provider Profile Details
NPI Number
1750598835
Provider Name
Bertha Ann Roark
Credential
RN
Provider Entity Type
Individual
Gender
Female
Address
310 La Jara St, Bloomfield, NM, 87413
Phone Number
505-634-3673
Fax Number
505-634-3675
Provider Enumeration Date
05/17/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
64434826 05 NM
institution
Provider Business Practice Location Address Details
Address
310 La Jara St
City
State
Zip
87413-6626
Phone Number
505-634-3673
Fax Number
505-634-3675
person
Provider Business Mailing Address Details
Address
310 La Jara St
City
State
Zip
87413-6626
Phone Number
505-634-3673
Fax Number
505-634-3675
person
Provider's Taxonomy Details 1
Type
Nursing Service Providers
Classification
Registered Nurse
Speciality
School
Taxonomy
License No.
R18502 (New Mexico)
Definition
Definition to come...
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