Individual
SAMARA ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
2107 STATION CLUB DR SW, MARIETTA, GA 30060-7517
(678) 540-2857
Mailing address
2107 STATION CLUB DR., MARIETTA, GA 30060-1227
(678) 540-2857
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN089484
GA
Other
Enumeration date
09/27/2011
Last updated
01/11/2016
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