Terri Roberson, LPN

Individual provider Active NPI Licensed Practical Nurse · Somerville, OH

NPI 1790021079 · NPPES record last updated Dec 14, 2012

Key facts

NPI
1790021079
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
PN098719 (OH)
Practice address
2103 Mendenhall Rd
Somerville, OH 45064-9430
Phone
(513) 267-6463
NPI assigned
Dec 14, 2012
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

State licenses

LicenseStateTypeSpecialty
PN098719OHMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X PN098719 OH Yes

Addresses

Primary practice location

2103 Mendenhall Rd
Somerville, OH 45064-9430

Mailing address

2103 Mendenhall Rd
Somerville, OH 45064-9430
Phone (513) 267-6463

Other providers in Somerville, OH

All providers in Somerville, OH · Licensed Practical Nurse in Ohio

Sources for this page

Verify at the official NPI Registry.