Individual
HEITH WILLIS ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSN/CRNA
Contact information
Practice address
900 HOSPITAL DR, MADISONVILLE, KY 42431-1644
(270) 825-5100
Mailing address
200 CLINIC DR, MADISONVILLE, KY 42431-1661
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
5899A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000599525
ANTHEM BCBS
KY
05
—
7100060970
—
KY
Enumeration date
01/16/2009
Last updated
01/08/2015
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