Individual
MRS. GWENDOLYN DALY ROARKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
MEDICAL CENTER BLVD, WINSTON SALEM, NC 27157-0001
(336) 716-3069
Mailing address
1803 PROVENCE DR, GREENSBORO, NC 27410-2866
(336) 638-4988
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
091812
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8051069
—
NC
Enumeration date
11/22/2005
Last updated
08/29/2007
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