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General NPI Number Information
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NPI Number | 1629324355
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Entity Type | Organization
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Legal Business Name | ROBERTSON HEALTH CARE CLINIC
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Dates
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Enumeration Date | 07/31/2012
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Last Update Date | 11/14/2012
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Provider Practice Location Address
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Address Line | 513 WALNUT ST
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City | MONROE
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State | LA
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Zip | 71201-6229
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Country | US
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Telephone | 318-372-2707
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Fax | 318-323-2221
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Provider Business Mailing Address
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Address Line | 513 WALNUT ST
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City | MONROE
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State | LA
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Zip | 71201-6229
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Country | US
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Telephone | 318-372-2707
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Fax |
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Authorized Official
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Title or Position | OWNER/OPERATOR
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Name | AMBER A ROBERTSON
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Credential | AFNP
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Telephone | 318-372-2707
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | AP06545
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License Number State | LA
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