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General NPI Number Information
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NPI Number | 1679198394
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Entity Type | Individual
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Provider Name | NORA PRISCILLA ROBERSON
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Gender | Female
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Dates
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Enumeration Date | 06/09/2020
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Last Update Date | 06/09/2020
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Provider Practice Location Address
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Address Line | 413 MILL ST
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City | ROCKY MOUNT
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State | NC
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Zip | 27804-4837
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Country | US
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Telephone | 252-801-5650
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Fax |
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Provider Business Mailing Address
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Address Line | 6101 WILLIAM CT
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City | ROCKY MOUNT
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State | NC
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Zip | 27803-7814
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Country | US
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Telephone | 252-801-5650
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | CT-3099
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License Number State | NC
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