Roberts, Mary Jeanne

Roberts, Mary Jeanne is an individual health care provider with primary practice located at 2525 Glenn Hendren Dr , Liberty MO 64068-9625. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant, which is considered as her primary health care specialty. Roberts, Mary Jeanne can be contacted via phone (816) 792-7126.

Contact Information

Primary practice address
2525 Glenn Hendren Dr Liberty MO 64068-9625
Phone: (816) 792-7126
Fax: (816) 792-7196
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Anesthesiologist Assistant 367H00000X 2008016062 Missouri

Profile Details

NPI number 1144485533
LBN Legal business name Roberts, Mary Jeanne
Credentials Associate of Arts (AA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 24th, 2008
Last updated Jul 29th, 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 1144485533 NPPES
Missouri Other P00639280 RR MEDICARE
Missouri MEDICAID 1144485533 RR MEDICARE

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