Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LA2200X | Nurse Practitioner - Adult Health | 5005187 | NC |
N | 363LG0600X | Nurse Practitioner - Gerontology | 5005187 | NC |
NPI | 1033404603 |
---|---|
Provider Name | Rebecca Fields Roth |
First Address | Asheboro, NC 27203-8600 |
Second Address | Climax, NC 27233-9171 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2011 |
Last Update Date | 22/03/2017 |