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NPI Code Detail

MEDICARE: DR. KATHLEEN ANNE ROBERTS DNP

MEDICARE: DR. KATHLEEN ANNE ROBERTS DNP
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363LF0000XFamily Nurse Practitioner95193472CA
2363LF0000XFamily Nurse Practitioner5173TN
3363LF0000XFamily Nurse PractitionerCNP211353ME
4363LF0000XFamily Nurse PractitionerAP60728469WA
5363LF0000XFamily Nurse Practitioner201708253OR

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053307090
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KATHLEEN ANNE ROBERTS DNP
Provider Business Mailing Address
First Line : 6025 STAGE RD STE 42-415
Second Line :
City : BARTLETT
State : TN
Zip : 38134-8374
Country : US
Telephone Number : 901-498-0054
Fax Number : 888-419-2656
Provider Business Practice Location Address
First Line : 2725 SW CEDAR HILLS BLVD STE 200
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-1435
Country : US
Telephone Number : 503-352-6000
Fax Number : 503-352-6081
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/26/2005
Last Update Date : 01/09/2023

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