Shelly Gunnell Roark, Nurse Practitioner
Nurse Practitioner, Women's Health in Hattiesburg, MS. Individual provider (NPI-1).
NPI number1083170559
StatusActive
Last updated in NPPESFeb 24, 2025
Details
- NPI
- 1083170559
- Entity type
- Individual (NPI-1)
- Name
- Shelly Gunnell Roark
- Credential
- Nurse Practitioner
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Feb 20, 2019
- Certification date
- Feb 6, 2025
- Last updated
- Feb 24, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LW0102X | Nurse Practitioner, Women's Health | 902947 | MS | Yes |
| 363LC1500X | Nurse Practitioner, Community Health | 902947 | MS |
Practice location
5003 Hardy St Ste 350Hattiesburg, MS 39402-1323
Phone 601-268-9393 · Fax 601-268-9559
Mailing address
6524 U S Highway 98Hattiesburg, MS 39402-8569
Phone 601-268-9393 · Fax 601-268-9559
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Other Women's Health Nurse Practitioner providers in Hattiesburg, MS
- Candace Johnson, WHNP-BCNPI 1427556349
- Laura Usnik Long, WHNP-BCNPI 1649650854
- Tracy Roseberry, WHNPNPI 1083691489
- Laura Claire Singley, WHNPNPI 1023064276
- Traci Davis Suber, WHNPNPI 1962628966
All 6 Women's Health Nurse Practitioner providers in Hattiesburg · All 3,372 providers in Hattiesburg
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