MEDICARE: AIMEE A. 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
1	363LP0200X	Pediatric Nurse Practitioner	224349	LA
2	363LN0005X	Critical Care Neonatal Nurse Practitioner	224349	LA

General Provider Information

NPI Number	:	1790432896
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AIMEE A. ROBERTSON

Provider Business Mailing Address
First Line	:	21196 LA HIGHWAY 444
Second Line	:
City	:	LIVINGSTON
State	:	LA
Zip	:	70754-5104
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	10130 CROSSING WAY STE 330
Second Line	:
City	:	DENHAM SPRINGS
State	:	LA
Zip	:	70726-5890
Country	:	US
Telephone Number	:	225-667-2777
Fax Number	:

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

Provider Enumeration Date	:	03/08/2022
Last Update Date	:	03/30/2026

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