Individual
AMANDA R ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
601 MED TECH PKWY, JOHNSON CITY, TN 37604-2253
(423) 610-1020
Mailing address
1009 LARK ST STE 2, JOHNSON CITY, TN 37604-8218
(423) 844-2686
(423) 844-2688
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
82957
TN
Other
Enumeration date
01/26/2010
Last updated
04/25/2019
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