Healthcare Provider Details

I. General information

NPI: 1316271448
Provider Name (Legal Business Name): KRISTINA E. ROBERTS ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/22/2009
Last Update Date: 10/20/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16560 N NEBRASKA AVE
LUTZ FL
33549-6172
US

IV. Provider business mailing address

8 CADILLAC DR STE. 250
BRENTWOOD TN
37027-5087
US

V. Phone/Fax

Practice location:
  • Phone: 813-490-0909
  • Fax: 813-490-0910
Mailing address:
  • Phone: 615-425-4225
  • Fax: 615-425-4271

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1741652
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: