Individual
JASON WILLIAM ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
9427 EASTSIDE DRIVE EXT STE A, NEWTON, MS 39345-8063
(601) 683-0330
Mailing address
611 N 39TH AVE, YAKIMA, WA 98902-6348
(601) 757-5718
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
903294
MS
Other
Enumeration date
07/29/2019
Last updated
09/15/2019
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