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General NPI Number Information
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NPI Number | 1376320150
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Entity Type | Individual
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Provider Name | KAYLEE MARLENE ROBERTS FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/13/2023
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Last Update Date | 09/04/2024
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Provider Practice Location Address
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Address Line | 1919 S SHILOH RD STE 333
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City | GARLAND
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State | TX
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Zip | 75042-8235
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Country | US
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Telephone | 972-864-2050
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Fax | 972-271-3437
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Provider Business Mailing Address
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Address Line | 1919 S SHILOH RD STE 333
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City | GARLAND
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State | TX
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Zip | 75042-8235
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Country | US
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Telephone | 972-864-2050
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Fax | 972-271-3437
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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 | 1135945
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License Number State | TX
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