Individual
JENNIFER ROARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
1856 THOMPSON BRIDGE RD STE 14, GAINESVILLE, GA 30501-1620
(770) 219-9460
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN097864
GA
363LP2300X
Primary Care Nurse Practitioner
RN097864
GA
Other
Enumeration date
06/27/2005
Last updated
10/07/2020
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