Provider Demographics
NPI:1205010592
Name:ROBERTSON, MATTHEW P (ACNP)
Entity Type:Individual
Prefix:
First Name:MATTHEW
Middle Name:P
Last Name:ROBERTSON
Suffix:
Gender:M
Credentials:ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 801443
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22908-1443
Mailing Address - Country:US
Mailing Address - Phone:434-924-2288
Mailing Address - Fax:434-243-5116
Practice Address - Street 1:1215 LEE ST
Practice Address - Street 2:UNIVERSITY OF VIRGINIA HEALTH SYSTEM, STBICU
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22908-0816
Practice Address - Country:US
Practice Address - Phone:434-924-2288
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-12-21
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169716363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care