Individual
MS. BRENDA MARIE ROBERTS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
3457 LATTA RD, GREECE, NY 14612
(585) 369-5867
Mailing address
3457 LATTA RD, GREECE, NY 14612
(585) 369-5867
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
256713-1
NY
Other
Enumeration date
06/04/2014
Last updated
06/04/2014
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