MEDICARE: SHARON YVETTE ROBERTS NURSE PRACTITIONER

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	363LW0102X	Women's Health Nurse Practitioner	635449	TX

General Provider Information

NPI Number	:	1902923543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARON YVETTE ROBERTS NURSE PRACTITIONER

Provider Business Mailing Address
First Line	:	1327 SHIELDS AVE
Second Line	:
City	:	CEDAR HILL
State	:	TX
Zip	:	75104-1413
Country	:	US
Telephone Number	:	214-789-0961
Fax Number	:

Provider Business Practice Location Address
First Line	:	3920 W WHEATLAND RD
Second Line	:	SUITE 108
City	:	DALLAS
State	:	TX
Zip	:	75237-3401
Country	:	US
Telephone Number	:	214-948-7779
Fax Number	:	214-948-9977

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

Provider Enumeration Date	:	03/26/2007
Last Update Date	:	05/01/2012

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