MEDICARE: MS. MELISSA JOY ROBERTS JD, MSN, FNP-BC

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
1	363LF0000X	Family Nurse Practitioner	112429	MO

General Provider Information

NPI Number	:	1518938398
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MELISSA JOY ROBERTS JD, MSN, FNP-BC

Provider Business Mailing Address
First Line	:	9709 N VIRGINIA AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2199
Country	:	US
Telephone Number	:	816-734-1340
Fax Number	:

Provider Business Practice Location Address
First Line	:	9709 N VIRGINIA AVE
Second Line	:
City	:	KANSAS CITY
State	:	MO
Zip	:	64155-2199
Country	:	US
Telephone Number	:	816-734-1340
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/30/2006
Last Update Date	:	04/13/2012

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