Marsha Anne Roberts, RN

Individual provider Active NPI Registered Nurse · Lake Ozark, MO

NPI 1366238263 · NPPES record last updated Apr 17, 2025

Key facts

NPI
1366238263
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
2021039477 (MO)
Practice address
130 Calo LN
Lake Ozark, MO 65049-9208
Phone
(573) 746-7361
Fax
(573) 746-7303
NPI assigned
Apr 17, 2025
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
Credentials
Registered Nurse

State licenses

LicenseStateTypeSpecialty
041395630ILMDRegistered Nurse
2021039477MOMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 041395630 IL
Registered Nurse 163W00000X 2021039477 MO Yes

Addresses

Primary practice location

130 Calo LN
Lake Ozark, MO 65049-9208

Mailing address

5500 Ming Ave Ste 410
Bakersfield, CA 93309-4631

Other identifiers

IdentifierTypeStateIssuer
041395630OtherILLICENSE
2021039477OtherMOLICENSE

Other providers in Lake Ozark, MO

All providers in Lake Ozark, MO · Registered Nurse in Missouri

Sources for this page

Verify at the official NPI Registry.