Provider Demographics
NPI:1942725452
Name:ROBERTS, ERIN KRISTA
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KRISTA
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1704 W 14TH ST
Mailing Address - Street 2:
Mailing Address - City:PORT ANGELES
Mailing Address - State:WA
Mailing Address - Zip Code:98363-6810
Mailing Address - Country:US
Mailing Address - Phone:360-461-5771
Mailing Address - Fax:
Practice Address - Street 1:1704 W 14TH ST
Practice Address - Street 2:
Practice Address - City:PORT ANGELES
Practice Address - State:WA
Practice Address - Zip Code:98363-6810
Practice Address - Country:US
Practice Address - Phone:360-461-5771
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-04
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide