Individual
MS. ISLUV ROBERTSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
1405 E NORTHSIDE DR, JACKSON, MS 39211
(601) 594-0032
Mailing address
1405 E NORTHSIDE DR, JACKSON, MS 39211
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
895338
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
609309546
—
MS
05
—
6X3FM74DCP
—
MS
Enumeration date
08/03/2018
Last updated
08/03/2018
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