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Individual
MRS. SUSAN TRACY ROBERTS
Active
Individual
MRS. SUSAN TRACY ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Taxonomy
Speciality
Code
Description
License number
State
207QA0505X
Adult Medicine Physician
0024169878
VA
363L00000X
Nurse Practitioner
Primary
0024169878
VA
363LX0106X
Occupational Health Nurse Practitioner
5006199
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
363L00000X
TAXONOMY
VA
Enumeration date
03/01/2012
Last updated
07/30/2024
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