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General NPI Number Information
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NPI Number | 1760809800
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Entity Type | Individual
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Provider Name | JASMINE MOON ROBERTS M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/26/2014
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Last Update Date | 06/22/2025
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Provider Practice Location Address
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Address Line | 1401 W ASH ST
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City | GOLDSBORO
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State | NC
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Zip | 27530-1078
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Country | US
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Telephone | 919-947-8236
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Fax |
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Provider Business Mailing Address
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Address Line | 1401 W ASH ST
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City | GOLDSBORO
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State | NC
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Zip | 27530-1078
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Country | US
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Telephone | 919-947-8236
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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 | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | 29374
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License Number State | WV
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Taxonomy #2
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Taxonomy Code | 207QS1201X
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Taxonomy Name | Sleep Medicine (Family Medicine) Physician
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License Number | 2018-00038
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License Number State | NC
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