Individual
JENNIFER ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2828 BAYBORO ST, LORIS, SC 29569-2710
(843) 716-2229
Mailing address
784 BONITA LOOP, MYRTLE BEACH, SC 29588-6987
(803) 983-1133
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
27225
SC
Other
Enumeration date
06/02/2023
Last updated
06/02/2023
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