MEDICARE: CHRISTINA ROBERSON

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
1	376K00000X	Nurse's Aide

General Provider Information

NPI Number	:	1235651605
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRISTINA ROBERSON

Provider Business Mailing Address
First Line	:	3525 E 106TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-1817
Country	:	US
Telephone Number	:	216-727-8330
Fax Number	:

Provider Business Practice Location Address
First Line	:	3525 E.106 ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105
Country	:	US
Telephone Number	:	216-727-8330
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/07/2017
Last Update Date	:	07/21/2022

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