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Individual

TABATHA ANN ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
NP

Contact information

Practice address
600 MARY ST, EVANSVILLE, IN 47747-7834
(812) 450-7338
(812) 450-2193
Mailing address
PO BOX 3407, EVANSVILLE, IN 47733-3407
(812) 450-7338
(812) 450-2193

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71007262A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
016858006
PTAN
KS
05
201012910A
KS
Enumeration date
01/14/2013
Last updated
07/21/2022
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