Healthcare Provider Details

I. General information

NPI: 1144660002
Provider Name (Legal Business Name): DANDREA ROBERSON LPN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 03/28/2026
Certification Date: 03/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

518 BISHOP ST
AKRON OH
44307-2160
US

IV. Provider business mailing address

518 BISHOP ST
AKRON OH
44307-2160
US

V. Phone/Fax

Practice location:
  • Phone: 330-400-0320
  • Fax:
Mailing address:
  • Phone: 330-400-0320
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code372600000X
TaxonomyAdult Companion
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code376J00000X
TaxonomyHomemaker
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code3747P1801X
TaxonomyPersonal Care Attendant
License Number
License Number State
# 5
Primary TaxonomyY
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License NumberPN142026
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: