Bertha Ann Roark is a School in Bloomfield, New Mexico. Bertha Ann Roark practices all healthcare services and medical treatments related to School. The NPI Number for Bertha Ann Roark is 1750598835. The last update date is 2007-07-09.
Bertha Ann Roark's current location address is 712 N 3rd St., Bloomfield, New Mexico. You can contact this provider via phone number 5056343673 and fax number 5056343675. The mailing address for Bertha Ann Roark is 712 N 3rd St., Bloomfield, New Mexico. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bertha Ann Roark |
|---|---|
| Address | 712 N 3rd St., Bloomfield, New Mexico |
| Phone Number | 5056343673 |
| Fax Number | 5056343675 |
| Sole Proprietor | N |
| Credentials | RN |
NPI Number Detail
| NPI Number | 1750598835 |
|---|---|
| Provider Enumeration Date | 2007-05-17 |
| Last Updated Date | 2007-07-09 |
Provider Mailing Address Detail
| Address | 712 N 3rd St. |
|---|---|
| City | Bloomfield |
| State | New Mexico (NM) |
| Post Code | 87413 |
| Phone Number | 5056343673 |
| Fax Number | 5056343675 |
Provider's Primary Taxonomy Detail
| Speciality | School |
|---|---|
| Taxonomy | 163Ws0200X |
| Licence No | R18502 |
|
Definition: A registered nurse based at an elementary, middle or high school providing health services to students. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 64434826 | NM | -- |
Post Comment/ Review Below
What is the Bertha Ann Roark's 1750598835?
The Bertha Ann Roark's NPI (National Provider Identifier) Number is 1750598835. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please provide the complete street address where Bertha Ann Roark is physically located?
The Bertha Ann Roark is physically situated at the following address: 712 N 3Rd St., Bloomfield, NM, 87413.
What is Bertha Ann Roark's specialized field of practice, and what is the corresponding taxonomy classification code?
The Bertha Ann Roark's area of specialization is School, and the corresponding taxonomy code that categorizes this field of practice is 163Ws0200X.
On what date did the Centers for Medicare & Medicaid Services originally issue the 1750598835 to Bertha Ann Roark?
The Centers for Medicare & Medicaid Services originally issued the 1750598835 to Bertha Ann Roark on 2007-05-17.
As of what date were the details related to Bertha Ann Roark most recently updated or revised?
The information pertaining to Bertha Ann Roark, including its address, specialty, and other relevant details, was last updated or revised on 2007-07-09.