Provider Demographics
NPI:1932861010
Name:ROBERTS, PATRICIA STULB (RN, PMHCNS, NP)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:STULB
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:RN, PMHCNS, NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:905 RICHMOND RD
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23185-2821
Mailing Address - Country:US
Mailing Address - Phone:175-750-8272
Mailing Address - Fax:
Practice Address - Street 1:905 RICHMOND RD
Practice Address - Street 2:
Practice Address - City:WILLIAMSBURG
Practice Address - State:VA
Practice Address - Zip Code:23185-2821
Practice Address - Country:US
Practice Address - Phone:175-750-8272
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-10-06
Last Update Date:2021-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0015000678364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health