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Individual
JAMIE ROBERTS
Active
Individual
JAMIE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163WA0400X
Addiction (Substance Use Disorder) Registered Nurse
092000466RN
OR
163WP0000X
Pain Management Registered Nurse
Primary
092000466RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
210831
—
OR
Enumeration date
04/28/2010
Last updated
04/28/2010
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