Nicollette Roberison

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Princeton, LA

NPI 1073145397 · NPPES record last updated Feb 5, 2020

Key facts

NPI
1073145397
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
1217 Winfield Rd
Princeton, LA 71067-8343
Phone
(318) 286-7225
NPI assigned
Feb 5, 2020
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

1217 Winfield Rd
Princeton, LA 71067-8343

Mailing address

1217 Winfield Rd
Princeton, LA 71067-8343

Other providers in Princeton, LA

All providers in Princeton, LA · Student in an Organized Health Care Education/Training Program in Louisiana

Sources for this page

Verify at the official NPI Registry.