Provider Demographics
NPI:1699310367
Name:ROBERTS, ERIN (CPNP-PC)
Entity type:Individual
Prefix:MRS
First Name:ERIN
Middle Name:
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2774 LAKE SHADOW DR
Mailing Address - Street 2:
Mailing Address - City:CONROE
Mailing Address - State:TX
Mailing Address - Zip Code:77385-3206
Mailing Address - Country:US
Mailing Address - Phone:817-733-0041
Mailing Address - Fax:
Practice Address - Street 1:201 ENTERPRISE ROW STE 12
Practice Address - Street 2:
Practice Address - City:CONROE
Practice Address - State:TX
Practice Address - Zip Code:77301-4448
Practice Address - Country:US
Practice Address - Phone:936-760-2784
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-16
Last Update Date:2019-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP142387363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics