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NPI Code Detail

MEDICARE: KAITLYN ROBERTS PNP-PC

MEDICARE:   KAITLYN  ROBERTS  PNP-PC
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
1363LP0200XPediatric Nurse PractitionerRN10000367MA

General Provider Information

NPI Number : 1164285367
Entity Type Code : Individual
Provider Name (Legal Business Name) : KAITLYN ROBERTS PNP-PC
Provider Business Mailing Address
First Line : 10 GOVERNOR DOHERTY RD
Second Line :
City : BILLERICA
State : MA
Zip : 01821-2040
Country : US
Telephone Number : 978-987-9427
Fax Number :
Provider Business Practice Location Address
First Line : 652 E WASHINGTON ST UNIT 2
Second Line :
City : NORTH ATTLEBORO
State : MA
Zip : 02760-2488
Country : US
Telephone Number : 508-576-5010
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/01/2024
Last Update Date : 02/01/2024

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Directions to “ KAITLYN ROBERTS PNP-PC” Practice Location

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