MEDICARE: ELIZABETH LOVELAND ROBERTS NP

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	71007468A	IN

General Provider Information

NPI Number	:	1730604984
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LOVELAND ROBERTS NP

Provider Business Mailing Address
First Line	:	9102 N 600 W
Second Line	:
City	:	FOUNTAINTOWN
State	:	IN
Zip	:	46130-9531
Country	:	US
Telephone Number	:	317-372-7523
Fax Number	:

Provider Business Practice Location Address
First Line	:	5810 E 71ST ST
Second Line	:
City	:	INDIANAPOLIS
State	:	IN
Zip	:	46220-4002
Country	:	US
Telephone Number	:	317-845-9653
Fax Number	:

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

Provider Enumeration Date	:	08/09/2017
Last Update Date	:	09/19/2017

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