Provider Demographics
NPI:1902923543
Name:ROBERTS, SHARON YVETTE (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:
First Name:SHARON
Middle Name:YVETTE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1327 SHIELDS AVE
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-1413
Mailing Address - Country:US
Mailing Address - Phone:214-789-0961
Mailing Address - Fax:
Practice Address - Street 1:3920 W WHEATLAND RD
Practice Address - Street 2:SUITE 108
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75237-3401
Practice Address - Country:US
Practice Address - Phone:214-948-7779
Practice Address - Fax:214-948-9977
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2012-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX635449363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health