Individual
MS. REBECCA L ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP,CDE
Contact information
Practice address
136 S LUDLOW ST, FL. 1, DAYTON, OH 45402-1813
(937) 499-8273
(937) 223-9811
Mailing address
400 SUGAR CAMP CIR, SUITE 205, OAKWOOD, OH 45409-1963
(937) 395-3656
(937) 395-3657
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
291690
OH
163WD0400X
Diabetes Educator Registered Nurse
RN291690
OH
363LA2200X
Adult Health Nurse Practitioner
Primary
COA.10474-NP
OH
363LF0000X
Family Nurse Practitioner
NP-10474
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000599279
BCBS OHIO
OH
05
—
2948341
—
OH
01
—
421534506138
CARESOURCE OHIO
OH
Enumeration date
08/13/2008
Last updated
09/16/2015
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