Provider Demographics
NPI:1578934576
Name:ROBERTS, WHITNEE (NP)
Entity Type:Individual
Prefix:
First Name:WHITNEE
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:700 WYNDAM CT
Mailing Address - Street 2:
Mailing Address - City:LUMBERTON
Mailing Address - State:NC
Mailing Address - Zip Code:28358-2370
Mailing Address - Country:US
Mailing Address - Phone:910-734-6718
Mailing Address - Fax:
Practice Address - Street 1:401 W 27TH ST
Practice Address - Street 2:
Practice Address - City:LUMBERTON
Practice Address - State:NC
Practice Address - Zip Code:28358-3019
Practice Address - Country:US
Practice Address - Phone:910-370-0434
Practice Address - Fax:910-674-4585
Is Sole Proprietor?:No
Enumeration Date:2015-10-15
Last Update Date:2021-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5009308363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner