Individual
SHERENE ANDREA ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A.R.N.P.
Contact information
Practice address
1190 N STONE ST, DELAND, FL 32720-2511
(386) 738-1792
(386) 738-4865
Mailing address
940 VILLAGE TRL APT 1-205, PORT ORANGE, FL 32127-9383
(386) 453-6490
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
2994522
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305843300
—
FL
Enumeration date
11/01/2006
Last updated
07/08/2007
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