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General NPI Number Information
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NPI Number | 1538582531
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Entity Type | Individual
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Provider Name | MARCELLA ROBERTS CNP
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Gender | Female
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Dates
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Enumeration Date | 01/27/2014
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Last Update Date | 07/22/2025
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Provider Practice Location Address
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Address Line | 1096 BEECH ST
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City | WESSON
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State | MS
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Zip | 39191-6847
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Country | US
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Telephone | 601-643-6006
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Fax | 601-894-2514
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Provider Business Mailing Address
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Address Line | PO BOX 490
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City | MCCOMB
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State | MS
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Zip | 39649-0490
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Country | US
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Telephone | 601-249-2701
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Fax | 601-249-2195
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | R867044
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License Number State | MS
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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 | 867044
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License Number State | MS
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 867044
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License Number State | MS
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