Healthcare Provider Details

I. General information

NPI: 1780307603
Provider Name (Legal Business Name): JOSETTE LEE ROBERTS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/26/2022
Last Update Date: 10/24/2022
Certification Date: 10/24/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6609 VIRGINIA PKWY
MCKINNEY TX
75071-5513
US

IV. Provider business mailing address

1824 ABBY CREEK DR
LITTLE ELM TX
75068-0299
US

V. Phone/Fax

Practice location:
  • Phone: 972-542-8884
  • Fax:
Mailing address:
  • Phone: 214-274-0690
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code176B00000X
TaxonomyMidwife
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: