Roberts, Holly R
Roberts, Holly R is an individual health care provider with primary practice located at 12500 Aurora Dr , Pleasant Prairie WI 53158-1227. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Roberts, Holly R can be contacted via phone (262) 857-5000.Contact Information
Primary practice address
12500 Aurora Dr
Pleasant Prairie WI 53158-1227
Phone: (262) 857-5000
Fax: (262) 857-5001
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 5760-023 | Wisconsin |
Profile Details
| NPI number | 1962150946 |
|---|---|
| LBN Legal business name | Roberts, Holly R |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 17th, 2022 |
| Last updated | Aug 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1962150946 | NPPES |
| Wisconsin | MEDICAID | 100197616 |
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