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General NPI Number Information
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NPI Number | 1073953238
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Entity Type | Individual
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Provider Name | AUDREY JEAN ROBERTS MD
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Gender | Female
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Dates
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Enumeration Date | 07/02/2013
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Last Update Date | 04/12/2023
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Provider Practice Location Address
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Address Line | 1100 N SAN FRANCISCO ST STE B
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3260
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Country | US
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Telephone | 928-779-7851
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Fax | 928-213-9990
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Provider Business Mailing Address
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Address Line | 1100 N SAN FRANCISCO ST STE B
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City | FLAGSTAFF
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State | AZ
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Zip | 86001-3260
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Country | US
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Telephone | 928-779-7851
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Fax | 702-671-6883
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 10180297-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 20203
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License Number State | NV
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 65391
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License Number State | AZ
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