Individual
ANDREA LEIGH ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1018 6TH AVE, WORTHINGTON, MN 56187-2202
(507) 372-2941
Mailing address
PO BOX 5074, SIOUX FALLS, SD 57117-5074
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
R174683
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AC 000775
MD CRNA LICENSE
MD
01
—
L6-0A00586
DELAWARE CRNA LICENCE
DE
01
—
R174683
LICENSE
MD
Enumeration date
03/08/2007
Last updated
09/09/2019
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