=====================================================
General NPI Number Information
=====================================================
NPI Number | 1801770417
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | FELICIA ROBERSON APRN, FNP-C
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 08/05/2025
-----------------------------------------------------
Last Update Date | 10/09/2025
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 8819 QUINCY AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44106-3419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-844-3493
-----------------------------------------------------
Fax | 216-201-5488
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 8819 QUINCY AVE
-----------------------------------------------------
City | CLEVELAND
-----------------------------------------------------
State | OH
-----------------------------------------------------
Zip | 44106-3419
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 216-844-3493
-----------------------------------------------------
Fax | 216-201-5488
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | APRN.CNP.0039498
-----------------------------------------------------
License Number State | OH
-----------------------------------------------------