Individual
TATONYA MONIQUE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
14400 CLAYTON RD, BALLWIN, MO 63011-2713
(636) 207-1137
Mailing address
14400 CLAYTON RD, BALLWIN, MO 63011-2713
(636) 207-1137
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2017004145
MO
363LF0000X
Family Nurse Practitioner
209015544
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
F1116320
AANP CERTIFICATION
IL
Enumeration date
04/20/2017
Last updated
06/25/2024
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