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General NPI Number Information
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NPI Number | 1093954745
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Entity Type | Individual
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Provider Name | CINDY LATRICE ROBERTS FNP
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Gender | Female
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Dates
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Enumeration Date | 02/19/2009
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Last Update Date | 01/12/2022
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Provider Practice Location Address
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Address Line | 4500 STUART ST MONCRIEF ARMY COMMUNITY HOSPITAL
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City | COLUMBIA
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State | SC
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Zip | 29207-5700
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Country | US
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Telephone | 803-751-2060
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Fax | 803-751-2014
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Provider Business Mailing Address
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Address Line | 8900 WISCONSIN AVE, BLDG 17A, 3RD FLR WALTER REED NATIONAL MILITARY MEDICAL CENTER
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City | BETHESDA
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State | MD
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Zip | 20814
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Country | US
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Telephone | 301-788-7129
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 689948
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License Number State | TX
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