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NPI Code Detail

MEDICARE: MS. JAN MARIE ROBERSON L.P.N.

MEDICARE:  MS. JAN MARIE ROBERSON  L.P.N.
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
1164W00000XLicensed Practical NurseLP043322AZ

General Provider Information

NPI Number : 1528372752
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. JAN MARIE ROBERSON L.P.N.
Provider Business Mailing Address
First Line : PO BOX 2850
Second Line :
City : FLORENCE
State : AZ
Zip : 85132-3053
Country : US
Telephone Number : 520-866-3500
Fax Number : 520-868-0798
Provider Business Practice Location Address
First Line : 1000 S MAIN ST
Second Line :
City : FLORENCE
State : AZ
Zip : 85132-8132
Country : US
Telephone Number : 520-866-3500
Fax Number : 520-868-0798
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/29/2010
Last Update Date : 07/29/2010

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Directions to “ MS. JAN MARIE ROBERSON L.P.N.” Practice Location

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