Individual
JENENE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
140 LABELLE LN SW, MARIETTA, GA 30060-5555
(770) 403-3120
Mailing address
140 LABELLE LN SW, MARIETTA, GA 30060-5555
(770) 403-3120
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
RN140714
GA
363LG0600X
Gerontology Nurse Practitioner
Primary
RN140714
GA
Other
Enumeration date
12/29/2015
Last updated
01/03/2016
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