Healthcare Provider Details

I. General information

NPI: 1710267067
Provider Name (Legal Business Name): TERRY ANNE ROBERTS MSN, FNP, BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2011
Last Update Date: 11/12/2020
Certification Date: 11/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6350 US ROUTE 60 E
BARBOURSVILLE WV
25504-1232
US

IV. Provider business mailing address

PO BOX 1680
HUNTINGTON WV
25717-1680
US

V. Phone/Fax

Practice location:
  • Phone: 304-399-3350
  • Fax: 304-955-5047
Mailing address:
  • Phone: 304-525-3334
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number21768
License Number StateWV

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: