Provider Demographics
NPI:1134240906
Name:ROBERTO, NANCY C (CNP)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:C
Last Name:ROBERTO
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:C
Other - Last Name:ROBERTO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CNP
Mailing Address - Street 1:3333 BURNET AVE.
Mailing Address - Street 2:ML 5021
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45229-3039
Mailing Address - Country:US
Mailing Address - Phone:513-636-5582
Mailing Address - Fax:866-823-7996
Practice Address - Street 1:3333 BURNET AVE.
Practice Address - Street 2:ML 1013
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45229-3039
Practice Address - Country:US
Practice Address - Phone:513-636-4466
Practice Address - Fax:513-636-5846
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA.0432-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner