Doctor Name: | LORI G ROBERTS |
NPI Number: | 1033128004 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CPNP |
License Number: | RN070413 |
Business Practice Address: | 3815 Harrison Rd Loganville, GA - 300522462 |
Business Phone Number: | 6785276000 |
Business Fax Number: | 7704666201 |
Mailing Address: | 980 Lawrenceville Hwy, LAWRENCEVILLE |
State: | GA |
Postal Code: | 300454706 |
Phone Number: | 6785276000 |
Fax Number: | 7708221573 |
NPI Enumeration Date: | 08/07/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LP0200X |
License Number: | RN070413 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Pediatrics |
Taxonomy Definition: |