Doctor Name: | MS. KATHERINE MARIE ROBERTS |
NPI Number: | 1225064116 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | FNCP |
License Number: | 200550031NP |
Business Practice Address: | 150 Sw Arrow Waldport, OR - 97394 |
Business Phone Number: | 5415633197 |
Business Fax Number: | 5415636027 |
Mailing Address: | 150 Sw Arrow, WALDPORT |
State: | OR |
Postal Code: | 97394 |
Phone Number: | 5415633197 |
Fax Number: | 5415636027 |
NPI Enumeration Date: | 06/23/2006 |
NPI Last Update Date: | 03/05/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 200550031NP |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OR |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |