Provider Demographics
NPI:1740354091
Name:ROBERTS, KATHLEEN MEGAN (NREMT, INDEPENDENT D)
Entity type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:MEGAN
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:NREMT, INDEPENDENT D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1050 REGISTER STREET
Mailing Address - Street 2:COMMANDING OFFICER CGC OAR
Mailing Address - City:NORTH CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29405
Mailing Address - Country:US
Mailing Address - Phone:843-554-8541
Mailing Address - Fax:843-554-2543
Practice Address - Street 1:1050 REGISTER STREET
Practice Address - Street 2:COMMANDING OFFICER CGC OAR
Practice Address - City:NORTH CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29405
Practice Address - Country:US
Practice Address - Phone:843-554-8541
Practice Address - Fax:843-554-2543
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2009-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other