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General NPI Number Information
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NPI Number | 1487743571
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Entity Type | Individual
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Provider Name | ALICE J ROBERTS FNP
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Gender | Female
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Dates
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Enumeration Date | 10/12/2006
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Last Update Date | 08/10/2011
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Provider Practice Location Address
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Address Line | 757 BRYANT ST
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City | STATESVILLE
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State | NC
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Zip | 28677-4142
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Country | US
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Telephone | 704-873-5658
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Fax |
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Provider Business Mailing Address
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Address Line | 904 TROY MILL RD
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City | HAMPTONVILLE
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State | NC
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Zip | 27020-7265
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Country | US
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Telephone | 704-539-4086
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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 | 0001132012
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 5004976
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License Number State | NC
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