Organization
ROBERSONLTD
Active
Other names
Park Hill Family Practice
Organization subpart
No
Provider details
NPI number
Authorized official
MS. CHARLEZETTA ROBERSON PA (PHYSICIAN ASSISTANT)
(702) 871-3730
Entity
Organization
Contact information
Practice address
3211 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1953
(702) 871-3730
(702) 871-7379
Mailing address
3211 W CHARLESTON BLVD, LAS VEGAS, NV 89102-1953
(702) 871-3730
(702) 871-7379
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
—
363A00000X
Physician Assistant
546
NV
363AM0700X
Medical Physician Assistant
Primary
546
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2402116
—
NV
Enumeration date
03/07/2008
Last updated
04/05/2019
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