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General NPI Number Information
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NPI Number | 1245801380
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Entity Type | Organization
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Legal Business Name | DEREK ROBERTS APRN, P.A.
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Dates
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Enumeration Date | 07/09/2021
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Last Update Date | 07/09/2021
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Provider Practice Location Address
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Address Line | 8100 E 22ND ST N STE 1600-B
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City | WICHITA
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State | KS
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Zip | 67226-2321
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Country | US
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Telephone | 316-201-6424
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Fax |
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Provider Business Mailing Address
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Address Line | 8100 E 22ND ST N STE 1600-B
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City | WICHITA
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State | KS
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Zip | 67226-2321
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Country | US
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Telephone | 316-201-6424
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Fax | 316-201-6428
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Authorized Official
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Title or Position | APRN-BC
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Name | DEREK ROBERTS
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Credential | APRN-BC
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Telephone | 316-201-6424
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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