Individual
ETHEL LEE ROBERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3942 BITTER SPRINGS DR, FORT IRWIN, CA 92310-1597
(760) 900-2338
Mailing address
4TH AND INNER LOOP, FORT IRWIN, CA 92310-1597
(760) 380-3190
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
Primary
224780
TX
Other
Enumeration date
12/29/2006
Last updated
07/08/2007
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