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General NPI Number Information
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NPI Number | 1487325742
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Entity Type | Individual
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Provider Name | JAMIE LEIGH ROBERTS AGPCNP-BC
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Gender | Female
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Dates
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Enumeration Date | 09/25/2021
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Last Update Date | 01/21/2022
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Provider Practice Location Address
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Address Line | 740 S LIMESTONE
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City | LEXINGTON
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State | KY
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Zip | 40536-1203
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Country | US
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Telephone | 859-323-5661
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Fax | 859-323-6411
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Provider Business Mailing Address
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Address Line | 301 W CLINTON ST
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City | GEORGETOWN
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State | KY
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Zip | 40324-1203
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Country | US
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Telephone | 859-576-7850
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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 | 363LG0600X
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Taxonomy Name | Gerontology Nurse Practitioner
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License Number | 2021101533
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 3016833
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License Number State | KY
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