Individual
MS. SHELIA Y ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
289 SW STONEGATE TER, SUITE 103, LAKE CITY, FL 32024-3457
(386) 755-1655
(386) 755-2330
Mailing address
PO BOX 1642, LAKE CITY, FL 32056-1642
(386) 755-1655
(386) 755-2330
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
ARNP683592
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
303991900
—
FL
01
—
K9539
MEDICARE GROUP
FL
01
—
PTAN E6480V
LINKED TO GROUP PTAN IE881A EFFECTIVE 07/01/15
FL
Enumeration date
03/06/2006
Last updated
03/09/2016
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