Provider Demographics
NPI:1831939057
Name:ROBERTS, PATRICIA (BSN, RN)
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:BSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 BOULEVARD SOUTH SW STE 104
Mailing Address - Street 2:
Mailing Address - City:HUNTSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35802-2175
Mailing Address - Country:US
Mailing Address - Phone:256-417-2607
Mailing Address - Fax:
Practice Address - Street 1:600 BOULEVARD SOUTH SW STE 104
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35802-2175
Practice Address - Country:US
Practice Address - Phone:256-417-2607
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-27
Last Update Date:2024-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-119146163WC1500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1500XNursing Service ProvidersRegistered NurseCommunity Health