Roberts, Mary K
Roberts, Mary K is an individual health care provider with primary practice located at 109 Morrison Dr , Princeton WV 24740-2322. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. Roberts, Mary K can be contacted via phone (304) 487-3559.Contact Information
Primary practice address
109 Morrison Dr
Princeton WV 24740-2322
Phone: (304) 487-3559
Fax: (304) 487-7928
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered | 367500000X | 19857 | West Virginia |
Profile Details
| NPI number | 1083772156 |
|---|---|
| LBN Legal business name | Roberts, Mary K |
| Credentials | Certified Registered Nurse Anesthetist (CRNA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 4th, 2006 |
| Last updated | Jan 5th, 2015 - about 10 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1083772156 | NPPES |
| West Virginia | MEDICAID | 0066651000 |
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