Provider Demographics
NPI:1194297853
Name:ROBERTS, MAURICE J (FNP-C)
Entity type:Individual
Prefix:
First Name:MAURICE
Middle Name:J
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:MAURICE
Other - Middle Name:JEVON
Other - Last Name:ROBERTS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:FNP
Mailing Address - Street 1:GODOCS LLC
Mailing Address - Street 2:949 PINEY FOREST ROAD
Mailing Address - City:DANVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24540-1591
Mailing Address - Country:US
Mailing Address - Phone:434-835-4876
Mailing Address - Fax:434-835-4875
Practice Address - Street 1:GODOCS LLC
Practice Address - Street 2:949 PINEY FOREST ROAD
Practice Address - City:DANVILLE
Practice Address - State:VA
Practice Address - Zip Code:24540-1591
Practice Address - Country:US
Practice Address - Phone:434-835-4876
Practice Address - Fax:434-835-4875
Is Sole Proprietor?:No
Enumeration Date:2018-12-19
Last Update Date:2025-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024177069363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024177069OtherAPPLICATION IN PROCESS