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Individual

JESSICA R ROBERTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PMHNP-BC

Contact information

Practice address
6701 PETERS CREEK RD STE 110, ROANOKE, VA 24019-4060
(800) 765-7130
(201) 228-9980
Mailing address
6701 PETERS CREEK RD STE 110, ROANOKE, VA 24019-4060
(800) 765-7130
(201) 228-9980

Taxonomy

Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
0024184077
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1568093672
VA
Enumeration date
04/09/2022
Last updated
11/22/2024
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