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MRS. BERTHA ANN ROARK RN
NPI 1750598835
Registered Nurse - School in Bloomfield, NM

Active since May 17, 2007
310 LA JARA ST, BLOOMFIELD, NM 87413(505) 634-3673(505) 634-3675 Get Directions Write a Review

NPPES record last updated: July 9, 2007. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Mrs. Bertha Ann Roark Rn NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MRS. BERTHA ANN ROARK RN (NPI 1750598835) is an individual school provider in Bloomfield, New Mexico, licensed in New Mexico (R18502) and active in the NPI registry since May 2007.

NPPES Registry Identity

NPI1750598835
Entity TypeIndividualFemale
Primary Taxonomy163WS0200X
Provider Legal NameMRS. BERTHA ANN ROARKCredential: RN
Location Address310 LA JARA STBloomfield, NM 87413-6626
Mailing Address712 N 3rd St.Bloomfield, NM 87413 · (505) 634-3673 · Fax (505) 634-3675
Phone(505) 634-3673
Fax(505) 634-3675
Sole ProprietorNo
Enumeration DateMay 17, 2007
Last NPPES UpdateJuly 9, 2007
✔ NPI 1750598835 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRegistered Nurse · SchoolNursing Service Providers
Taxonomy Code163WS0200X
License✔ Licensed in NM · R18502
310 LA JARA ST, Bloomfield, NM 87413
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Other Identifiers 1

Medicaid64434826NM

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

SHARLEE ASHLEY
Registered Nurse (School)
310 LA JARA ST
BLOOMFIELD, NM 87413
San Juan County (505) 634-3891
KATHLEEN HENDERSON LBSW
Social Worker (School)
310 LA JARA ST
BLOOMFIELD, NM 87413
San Juan County (505) 634-3863
MRS. BERNADETTE DIANN ENRIQUEZ RN
Registered Nurse (School)
310 LA JARA ST
BLOOMFIELD, NM 87413
San Juan County (505) 634-3891
DOLORES ANN PYLES
Social Worker (School)
310 LA JARA ST
BLOOMFIELD, NM 87413
San Juan County (505) 634-3883
DEEANN STOTZ SLP
Speech-Language Pathologist
310 LA JARA ST
BLOOMFIELD, NM 87413
San Juan County (505) 634-3868

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Bertha Roark's NPI number?

The NPI number for Bertha Roark is 1750598835. It was assigned to this individual provider in the NPPES registry on May 17, 2007.

Where is Bertha Roark located?

Bertha Roark practices at 310 La Jara St, Bloomfield, NM 87413. The listed phone number is (505) 634-3673.

What is Bertha Roark's specialty?

The primary specialty registered for this NPI is Registered Nurse, specializing in School, with taxonomy code 163WS0200X.

When was this NPI record last updated?

The NPPES record for Bertha Roark was last updated on July 9, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.