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Individual
BRENDA ROBERTS
Active
Individual
BRENDA ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
1062138
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
20098018
—
KY
Enumeration date
06/02/2009
Last updated
06/02/2009
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