IndividualActive
Addison Roark, PA
NPI 1225834922 · Physician Assistant · Tulsa, OK
Provider details
- NPI number
- 1225834922
- Entity type
- Individual
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- License
- 5471 (OK)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
12902 E 51st St Ste 3
Tulsa, OK 74134-6712
Phone: (918) 994-3482
Approximate (ZIP-level) locationGet directions
Mailing address
4209 N Redbud Pl
Broken Arrow, OK 74012-0453
Registry dates
- Enumerated
- 2025-02-22
- Last updated
- 2025-02-22
- Certified
- 2025-02-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.