# STACI A ROBERTS

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1245965623
- **Gender:** F
- **Credential:** RN

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 163WG0000X | General Practice Registered Nurse | 200842075RN | OR | Yes |

## Other

- **Enumeration date:** 07/20/2022
- **Last updated:** 07/20/2022

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 200842075RN | OREGON BOARD OF NURSING | OR |