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General NPI Number Information
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NPI Number | 1548653017
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Entity Type | Individual
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Provider Name | HEATHER ROBERTS NP
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Gender | Female
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Dates
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Enumeration Date | 03/09/2015
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Last Update Date | 03/17/2016
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Provider Practice Location Address
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Address Line | 780 CANTON RD NE SUITE 410
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City | MARIETTA
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State | GA
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Zip | 30060-7241
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Country | US
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Telephone | 678-370-0370
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Fax |
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Provider Business Mailing Address
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Address Line | 780 CANTON RD NE STE 410
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City | MARIETTA
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State | GA
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Zip | 30060-7298
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Country | US
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Telephone | 678-370-0370
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Fax | 678-370-0371
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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 | RN188947
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License Number State | GA
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