Individual
OCTAVIA J ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NURSE PRACTITIONER
Contact information
Practice address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 475-6311
Mailing address
1536 N JEFFERSON ST, JACKSONVILLE, FL 32209-6525
(904) 475-6311
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
62090
NM
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
APRN11013255
FL
Other
Enumeration date
06/17/2020
Last updated
10/14/2021
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