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:
Health care specialties
| Specialty | Code | License # | 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 3 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1588094825 | NPPES |
| Ohio | MEDICAID | 0424687 |
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