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Individual

ALICE J ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
757 BRYANT ST, STATESVILLE, NC 28677-4142
(704) 873-5658
Mailing address
904 TROY MILL RD, HAMPTONVILLE, NC 27020-7265
(704) 539-4086

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
0001132012
WV
363LF0000X
Family Nurse Practitioner
Primary
5004976
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0001743447
BCBS
WV
05
3810004033
WV
Enumeration date
10/12/2006
Last updated
08/10/2011
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