Individual
LEIANN ROBERTS BOARDS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 422-6190
Mailing address
720 JUNIPER ST, COLUMBIA, SC 29203-5059
(803) 422-6190
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
23849
SC
Other
Enumeration date
03/23/2021
Last updated
03/23/2021
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