Individual
MICHELLE L ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
905C S FRONTAGE RD, MERIDIAN, MS 39301-6113
(601) 486-4210
(601) 482-4219
Mailing address
PO BOX 5208, MERIDIAN, MS 39302-5208
(601) 486-4210
(601) 486-4219
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
A810516
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08106745
—
MS
Enumeration date
07/17/2013
Last updated
02/18/2014
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