Individual provider · Type 1 NPI
Shannon Marie Roberts, APRN
Family Nurse Practitioner · Peoria, IL
NPI number
1215533245
Active
Practice location
530 NE Glen Oak Ave
Peoria, IL 61637-0001
Mailing address
10203 W Guinivere Dr
Mapleton, IL 61547-9586
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Family Nurse Practitioner Primary | 363LF0000X | 209021936 (IL) |
Family Nurse Practitioner: Definition to come...
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About NPI 1215533245
Shannon Marie Roberts, APRN's National Provider Identifier is 1215533245, issued on Dec 6, 2020. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Peoria, IL. The record was last updated on Dec 7, 2020.