Individual provider · NPI-1

Sandra Roberts

Student in an Organized Health Care Education/Training Program · Muskogee, OK

NPI number1063123784
StatusActive
Last updated in NPPESDec 13, 2022

Details

NPI
1063123784
Entity type
Individual (NPI-1)
Name
Sandra Roberts
Sex
Female
Sole proprietor
No
Enumeration date
Dec 13, 2022
Certification date
Dec 13, 2022
Last updated
Dec 13, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

455 N 19th St
Muskogee, OK 74401-3020

Phone 918-310-8026

Mailing address

455 N 19th St
Muskogee, OK 74401-3020

Phone 918-310-8026

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