Jeannie Charmaine Roberts, R.N.
Individual provider Active NPI Pediatric Registered Nurse · Alexander, AR
NPI 1114219003 · NPPES record last updated May 10, 2011
Key facts
- NPI
- 1114219003
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pediatric Registered Nurse 163WP0200X
- License
- RA49280 (AR)
- Practice address
- 1010 Silver Leaf Dr
Alexander, AR 72002-7826 - Phone
- (501) 909-9027
- NPI assigned
- May 10, 2011
- 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
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RA49280 | AR | MD | Pediatric Registered Nurse |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Registered Nurse | 163WP0200X | RA49280 | AR | Yes |
Addresses
Primary practice location
1010 Silver Leaf Dr
Alexander, AR 72002-7826
Mailing address
1010 Silver Leaf Dr
Alexander, AR 72002-7826
Phone (501) 909-9027
Other providers in Alexander, AR
- Victoria Powell
- Precision Spine, PLLC
- Providing a Ride LLC
- Restored Motherhood Doula Services LLC
- Rite of Passage, Inc
- Lonnell O Seamster Sr.
- Elizabeth Jean Shook
- Sondra'S Love and Care Transportation, LLC
- State of Arkansas
- Charles Martin Stewart
All providers in Alexander, AR · Pediatric Registered Nurse in Arkansas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 10, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.