Individual
JASON ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
500 KIRTS BLVD STE 200, TROY, MI 48084-4140
(248) 824-6500
Mailing address
PO BOX 40412, BELFAST, ME 04915-1255
(248) 824-6600
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
4704219864
MI
363LF0000X
Family Nurse Practitioner
Primary
4704219864
MI
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
4704219864
MI
Other
Enumeration date
07/18/2016
Last updated
04/23/2026
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