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NPI Code Detail

MEDICARE: ERICKA ROBERTS RN

MEDICARE: ERICKA ROBERTS RN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WA2000XAdministrator Registered Nurse823889NV

General Provider Information

NPI Number : 1376390625
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERICKA ROBERTS RN
Provider Business Mailing Address
First Line : 3332 LUNAR SKY ST
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89032-8234
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 250 PILOT RD STE 250
Second Line :
City : LAS VEGAS
State : NV
Zip : 89119-3514
Country : US
Telephone Number : 702-982-3292
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/03/2024
Last Update Date : 05/03/2024

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