Individual
SARA DIANE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
2401 W MAIN ST, MARION, IL 62959-1188
(618) 997-5311
Mailing address
PO BOX 552, ANNA, IL 62906-0552
(618) 833-6984
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
2007006168
MO
Other
Enumeration date
04/18/2007
Last updated
07/08/2007
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