Organization
MICHELE ROBERTS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHELE ROBERTS GNP (GNP)
(636) 244-4500
Entity
Organization
Contact information
Practice address
6209 MID RIVERS MALL DR, #317, SAINT PETERS, MO 63304-1102
(636) 244-4500
(636) 244-4505
Mailing address
6209 MID RIVERS MALL DR, #317, SAINT PETERS, MO 63304-1102
(636) 244-4500
(636) 244-4505
Taxonomy
Speciality
Code
Description
License number
State
363LG0600X
Gerontology Nurse Practitioner
Primary
103362
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
DB9981
RAILROAD MEDICARE
MO
Enumeration date
11/05/2007
Last updated
11/21/2007
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