Shelly Gunnell Roark, NURSEPRACTITIONER
Shelly Gunnell Roark, NURSEPRACTITIONER is a Nurse Practitioner in Hattiesburg, Mississippi. Qualified in 2016, 10 years ago. Practices with Southern Women's Health, PLLC, a 42-clinician group and accepts Medicare assignment. Licensed in Mississippi.
- Years since qualifying
- 10
- Licensed in
- MS
- In the registry since
- 2019
- Specialties on file
- 2
Practice location Address checks out
5003 Hardy St Ste 350Hattiesburg, MS 39402-1323
Phone: (601) 268-9393
Fax: (601) 268-9559
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Women's Health Nurse Practitioner (primary) | Taxonomy 363LW0102X · Licence 902947 (MS) |
|---|---|
| Community Health Nurse Practitioner | Taxonomy 363LC1500X · Licence 902947 (MS) |
Record details
| NPI number | 1083170559 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Female |
| Credentials | NURSEPRACTITIONER |
| Sole proprietor | No |
| NPI enumerated | February 20, 2019 |
| Last updated in NPPES | February 24, 2025 |
| Certification date | February 6, 2025 |
Medicare enrollment
| Medicare specialty | NURSE PRACTITIONER |
|---|---|
| Medical school | OTHER |
| Graduated | 2016 (10 years in practice) |
| Group practice | Southern Women'S Health, Pllc — 42 clinicians |
| Accepts Medicare assignment | Yes — accepts the Medicare-approved amount |
| Practice locations | 3 on file with Medicare |