Individual
ANDREW GODFREY ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPNP-PC
Contact information
Practice address
2500 N STATE ST, JACKSON, MS 39216-4500
(601) 984-1000
Mailing address
2500 N STATE ST, JACKSON, MS 39216-4500
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
900730
MS
363LP0200X
Pediatric Nurse Practitioner
Primary
906479
MS
Other
Enumeration date
02/28/2022
Last updated
06/03/2025
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