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Individual
MARK ROARK
Active
Individual
MARK ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3008480
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100294960
—
KY
Enumeration date
01/24/2014
Last updated
11/18/2024
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