Individual
MRS. LISA GAYLE ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
620 JHN PAUL JNS CIR, PORTSMOUTH, VA 23708-2111
(757) 953-5752
Mailing address
615 RALEIGH AVE, NORFOLK, VA 23507-2014
(757) 515-1733
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
0001192223
VA
163W00000X
Registered Nurse
Primary
76606
HI
Other
Enumeration date
06/03/2014
Last updated
06/03/2014
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