Individual
CLARICE ROTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP-C
Contact information
Practice address
LOWER LEVEL REYNOLDS GYM-WINGATE ROAD, WINGATE ROAD, WINSTON-SALEM, NC 27109
(336) 758-5218
(336) 758-6054
Mailing address
PO BOX 398, GERMANTON, NC 27019-0398
(336) 591-7351
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
21960
NC
Other
Enumeration date
02/12/2007
Last updated
03/07/2023
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