Roberts, Mark

Roberts, Mark is an sole proprietor health care provider with primary practice located at 122 Wyoming St , Dayton OH 45409-2731. He recently has 3 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health, Nursing Service Providers / Licensed Practical Nurse. Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health is his primary health care specialty. Roberts, Mark can be contacted via phone (937) 223-4461.

Contact Information

Primary practice address
122 Wyoming St Dayton OH 45409-2731
Phone: (937) 223-4461
Fax: (937) 449-7603
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APRN.CNP.0027441 Ohio
Physician Assistants & Advanced Practice Nursing Providers / Psychiatric/Mental Health 363LP0808X APRN.CNP.0027441 Ohio
Nursing Service Providers / Licensed Practical Nurse 164W00000X PN151753-M-IV Ohio

Profile Details

NPI number 1588094825
LBN Legal business name Roberts, Mark
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 23rd, 2013
Last updated Nov 8th, 2023 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1588094825 NPPES
Ohio MEDICAID 0424687

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