Individual
MARY JEANNE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AA
Contact information
Practice address
2525 GLENN HENDREN DR, LIBERTY, MO 64068-9625
(816) 792-7126
(816) 792-7196
Mailing address
PO BOX 804408, KANSAS CITY, MO 64180-4408
(913) 642-4900
(913) 381-0979
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2008016062
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144485533
—
MO
01
—
P00639280
RR MEDICARE
MO
Enumeration date
07/24/2008
Last updated
07/29/2021
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