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General NPI Number Information
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NPI Number | 1922535277
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Entity Type | Individual
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Provider Name | KATHERINE ROBERTS NP
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Gender | Female
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Dates
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Enumeration Date | 05/17/2017
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Last Update Date | 10/16/2024
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Provider Practice Location Address
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Address Line | 580 W 8TH ST
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City | JACKSONVILLE
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State | FL
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Zip | 32209-6533
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Country | US
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Telephone | 904-383-1022
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 44008
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City | JACKSONVILLE
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State | FL
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Zip | 32231-4008
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Country | US
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Telephone | 904-383-1022
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 2017007175
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | ARNP9314185
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License Number State | FL
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