Individual
KELLY ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
20 ALPINE DR, BATESVILLE, IN 47006-8477
(812) 932-3224
Mailing address
15923 STATE ROAD 156, PATRIOT, IN 47038-9210
(812) 290-7637
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
28154325A
IN
363LF0000X
Family Nurse Practitioner
APRN.CNP.024625
OH
Other
Enumeration date
05/09/2019
Last updated
05/09/2019
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