Individual
JUSTIN T ROACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN, NP-C
Contact information
Practice address
1301 W 12TH AVE, EMPORIA, KS 66801-2587
(620) 343-2376
(620) 343-5987
Mailing address
1201 W 12TH AVE, EMPORIA, KS 66801-2504
(620) 343-2376
(620) 343-5987
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
53-78756-082
KS
Other
Enumeration date
06/08/2019
Last updated
06/19/2026
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