Provider Demographics
NPI:1669776027
Name:ROBERSON, NORIKO U (NP-C)
Entity type:Individual
Prefix:MISS
First Name:NORIKO
Middle Name:U
Last Name:ROBERSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1319 W HIGHLAND ST
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85224-2705
Mailing Address - Country:US
Mailing Address - Phone:480-782-7529
Mailing Address - Fax:
Practice Address - Street 1:1319 W HIGHLAND ST
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85224-2705
Practice Address - Country:US
Practice Address - Phone:480-782-7529
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-12-28
Last Update Date:2010-12-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZAP3893363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily