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General NPI Number Information
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NPI Number | 1376213884
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Entity Type | Individual
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Provider Name | JENAE ROBERTZ
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Gender | Female
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Dates
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Enumeration Date | 09/16/2021
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Last Update Date | 09/16/2021
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Provider Practice Location Address
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Address Line | 1522 JANES AVE
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City | SAGINAW
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State | MI
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Zip | 48601-1819
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Country | US
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Telephone | 989-755-3633
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Fax | 989-755-3614
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Provider Business Mailing Address
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Address Line | 11 W HANNUM BLVD
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City | SAGINAW
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State | MI
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Zip | 48602-1938
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Country | US
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Telephone | 269-368-8247
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5302413573
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License Number State | MI
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