Jackie Roberts, LPN

NPI #1174678189 in Cheyenne, Wyoming

Provider Information

NPI Number
1174678189
Entity Type
Individual
Name
Jackie Roberts, LPN
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Licensed Practical Nurse
Credential
LPN
Enumeration Date
Jan 23, 2007
Last Updated
Jul 8, 2007

Practice Location

Address
300 E PROSSER RD LOT 11
State
Wyoming
ZIP Code
82007-3128
Phone
(307) 635-3972

Specialties & Taxonomy Codes

Specialty
Licensed Practical Nurse

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