Individual
MR. TYRONE G ROBERSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGPCNP-BC
Contact information
Practice address
6439 GARNERS FERRY, COLUMBIA, SC 29209
(803) 776-4000
Mailing address
6439 GARNERS FERRY, COLUMBIA, SC 29209
(803) 776-4000
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
69630
SC
164W00000X
Licensed Practical Nurse
PR27111
SC
363L00000X
Nurse Practitioner
Primary
19344
SC
Other
Enumeration date
03/20/2011
Last updated
09/01/2016
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