Individual
MRS. MARY K ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
109 MORRISON DR, PRINCETON, WV 24740-2322
(304) 487-3559
(304) 487-7928
Mailing address
PO BOX 1143, PRINCETON, WV 24740-1143
(304) 487-3559
(304) 487-7928
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
19857
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0066651000
—
WV
Enumeration date
12/04/2006
Last updated
01/05/2015
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