Individual
ANTHONY JAMES ROBERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD, PMHNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
186811
NC
2084P0800X
Psychiatry Physician
Primary
1113909
AL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
9365822
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
950018
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2041002
CIGNA
NC
05
—
6005012
—
NC
01
—
825072000
MAGELLAN
NC
01
—
NCMC034223
NC HEALTHCHOICE VALUE OPT
NC
Enumeration date
09/26/2006
Last updated
12/04/2019
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