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NPI Code Detail

MEDICARE: JOEL A. ROBERTS

MEDICARE: JOEL A. ROBERTS
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
1163WG0000XGeneral Practice Registered Nurse159231LA
2367500000XCertified Registered Nurse Anesthetist245082LA
3390200000XStudent in an Organized Health Care Education/Training Program

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1245082OTHERLALICENSE

General Provider Information

NPI Number : 1790573947
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOEL A. ROBERTS
Provider Business Mailing Address
First Line : 5220 ESSEN LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3542
Country : US
Telephone Number : 225-526-1971
Fax Number :
Provider Business Practice Location Address
First Line : 5220 ESSEN LN
Second Line :
City : BATON ROUGE
State : LA
Zip : 70809-3542
Country : US
Telephone Number : 225-526-1971
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 04/28/2025
Last Update Date : 01/08/2026

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