Individual
MRS. JACEY A. ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1046 TULIP TER, ROCKINGHAM, VA 22801-5324
(540) 421-0779
(540) 438-0023
Mailing address
1412 FAIRMOUNT AVE, PHILADELPHIA, PA 19130-2908
(215) 599-4851
(215) 232-4093
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110005554
VA
363A00000X
Physician Assistant
Primary
MA054722
PA
Other
Enumeration date
01/24/2011
Last updated
12/23/2021
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