Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207KA0200X | Allergist | RN23860 | NV |
Y | 363L00000X | Nurse Practitioner | APRN00455 | NV |
NPI | 1316991615 |
---|---|
Provider Name | Patricia Roberts |
First Address | Las Vegas, NV 89133-5380 |
Second Address | Las Vegas, NV 89102-1535 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/05/2006 |
Last Update Date | 12/10/2017 |