Individual
JONATHAN MICHAEL ROBERTSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
APRN
Contact information
Practice address
1301 N RACE ST, GLASGOW, KY 42141-3483
(270) 651-4444
(270) 651-4892
Mailing address
1301 N RACE ST, GLASGOW, KY 42141-3483
(270) 651-4444
(270) 651-4892
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
3012416
KY
363L00000X
Nurse Practitioner
31293
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3012416
APRN STATE LICENSE
KY
05
—
7100538040
—
KY
Enumeration date
06/18/2018
Last updated
03/01/2023
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