Pamela Sue Robertson, LDO
Individual provider Active NPI Optician · Axton, VA
NPI 1306528732 · NPPES record last updated Aug 4, 2023
Key facts
- NPI
- 1306528732
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Optician 156FX1800X
- License
- 1101002008 (VA)
- Practice address
- 586 Sugartree Dr
Axton, VA 24054-1982 - Phone
- (276) 224-5164
- NPI assigned
- Aug 4, 2023
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1101002008 | VA | MD | Optician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Optician | 156FX1800X | 1101002008 | VA | Yes |
Addresses
Primary practice location
586 Sugartree Dr
Axton, VA 24054-1982
Mailing address
586 Sugartree Dr
Axton, VA 24054-1982
Phone (276) 224-5164
Other providers in Axton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 4, 2023. 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.