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Individual

STEPHANIE RAYE ROBERTS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2150 W ALAMEDA RD UNIT 1264, PHOENIX, AZ 85085-1916
(915) 342-2702
Mailing address
19014 N 76TH AVE, GLENDALE, AZ 85308-8300
(915) 342-2702

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
143639
AZ
367500000X
Certified Registered Nurse Anesthetist
Primary
283619
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
283619
CRNA
AZ
01
9438201
RN MULTI STATE LICENSE
FL
Enumeration date
11/10/2022
Last updated
11/10/2022
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