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General NPI Number Information
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NPI Number | 1891940649
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Entity Type | Individual
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Provider Name | EARNESTINE ROBERTS RN
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Gender | Female
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 09/12/2015
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Provider Practice Location Address
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Address Line | 3605 MEETING STREET RD. STE.B1
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City | NORTH CHARLESTON
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State | SC
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Zip | 29405
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Country | US
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Telephone | 843-552-8165
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Fax |
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Provider Business Mailing Address
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Address Line | 156 MANSFIELD BLVD
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City | NORTH CHARLESTON
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State | SC
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Zip | 29418-2001
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Country | US
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Telephone | 843-813-2017
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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 | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | R 60938
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 253Z00000X
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Taxonomy Name | In Home Supportive Care Agency
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License Number | IHCP-0240
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License Number State | SC
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