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NPI Code Detail

MEDICARE: CYNTHIA E ROBERTS FNP-BC

MEDICARE: CYNTHIA E ROBERTS FNP-BC
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 Practitioner46148KS
2363L00000XNurse Practitioner112198MO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2P00735197OTHERMORR MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1942488457
Entity Type Code : Individual
Provider Name (Legal Business Name) : CYNTHIA E ROBERTS FNP-BC
Provider Business Mailing Address
First Line : 4 RIVER RIDGE TER
Second Line :
City : SAINT JOSEPH
State : MO
Zip : 64507-7761
Country : US
Telephone Number : 816-344-4439
Fax Number :
Provider Business Practice Location Address
First Line : 4055 VALLEY VIEW LN STE 400
Second Line :
City : DALLAS
State : TX
Zip : 75244-5071
Country : US
Telephone Number : 877-570-9359
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/06/2008
Last Update Date : 09/12/2019

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Directions to “ CYNTHIA E ROBERTS FNP-BC” Practice Location

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