Provider Demographics
NPI:1619361060
Name:ROBERTS, HERMINA BARBARA ANN (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:HERMINA
Middle Name:BARBARA ANN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1650 SELWYN AVE
Mailing Address - Street 2:10TH FLOOR
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-7626
Mailing Address - Country:US
Mailing Address - Phone:718-960-1234
Mailing Address - Fax:718-960-2055
Practice Address - Street 1:1650 SELWYN AVE
Practice Address - Street 2:10TH FLOOR
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10457-7626
Practice Address - Country:US
Practice Address - Phone:718-960-1234
Practice Address - Fax:718-960-2055
Is Sole Proprietor?:No
Enumeration Date:2015-03-24
Last Update Date:2015-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY592943-1163W00000X
NYF339114-1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse