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NPI Code Detail

MEDICARE: MARIA ROBERTSON

MEDICARE: MARIA ROBERTSON
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
1363LA2200XAdult Health Nurse PractitionerCOA.16764-NPOH

General Provider Information

NPI Number : 1295132645
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIA ROBERTSON
Provider Business Mailing Address
First Line : 6150 OAK TREE BLVD
Second Line :
City : INDEPENDENCE
State : OH
Zip : 44131-6917
Country : US
Telephone Number : 216-581-6556
Fax Number :
Provider Business Practice Location Address
First Line : 4400 EASTON CMNS STE 125
Second Line :
City : COLUMBUS
State : OH
Zip : 43219-6223
Country : US
Telephone Number : 859-462-1955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2014
Last Update Date : 09/20/2018

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Directions to “ MARIA ROBERTSON ” Practice Location

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