Individual
HOLLY R ROBERTS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
12500 AURORA DR, PLEASANT PRAIRIE, WI 53158-1227
(262) 857-5000
(262) 857-5001
Mailing address
12500 AURORA DR, PLEASANT PRAIRIE, WI 53158-1227
(262) 857-5000
(262) 857-5001
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5760-023
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100197616
—
WI
Enumeration date
03/17/2022
Last updated
08/07/2023
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