Doctor Name: | JO BETH ROBERTS |
NPI Number: | 1003963885 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | NP |
License Number: | RN113509 |
Business Practice Address: | 777 Hemlock St Macon, GA - 312012102 |
Business Phone Number: | 4786336706 |
Business Fax Number: | 4786335384 |
Mailing Address: | 598 3rd St, MACON |
State: | GA |
Postal Code: | 312013357 |
Phone Number: | 4786336706 |
Fax Number: | 4786335384 |
NPI Enumeration Date: | 01/04/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | RN113509 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |