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General NPI Number Information
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NPI Number | 1053913376
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Entity Type | Individual
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Provider Name | ELIZABETH MARIE ROBERTS FNP-C
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Gender | Female
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Dates
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Enumeration Date | 11/11/2020
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Last Update Date | 08/16/2024
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Provider Practice Location Address
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Address Line | 2351 ERWIN RD
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City | DURHAM
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State | NC
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Zip | 27705-4699
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Country | US
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Telephone | 919-681-3937
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Fax | 919-684-0547
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Provider Business Mailing Address
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Address Line | 2351 ERWIN RD
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City | DURHAM
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State | NC
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Zip | 27705-4699
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Country | US
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Telephone | 919-681-3937
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Fax | 919-684-0547
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5017586
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 358538
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License Number State | NC
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