Roberts, Katie Renee

Roberts, Katie Renee is an individual health care provider with primary practice located at 647 N Broad Street Ext Ste 201, Grove City PA 16127-4604. 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, Katie Renee can be contacted via phone (724) 264-4190.

Contact Information

Primary practice address
647 N Broad Street Ext Ste 201 Grove City PA 16127-4604
Phone: (724) 264-4190
Fax: (724) 264-4194
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X MA052721 Pennsylvania

Profile Details

NPI number 1134396518
LBN Legal business name Roberts, Katie Renee
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2008
Last updated Sep 11th, 2021 - about 3 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1134396518 NPPES
Other 11976922 CAQH
MEDICAID 1J4395 CAQH

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