Individual
AMANDA J ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
835 S VAN BUREN ST, GREEN BAY, WI 54301-3526
(414) 290-6720
(414) 290-6755
Mailing address
4565 HILLTOP DR, SUAMICO, WI 54173-8428
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
1507-39
WI
363A00000X
Physician Assistant
Primary
4063-23
WI
363A00000X
Physician Assistant
—
—
Other
Enumeration date
11/18/2013
Last updated
12/21/2021
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