Provider Demographics
NPI:1891684957
Name:ROBERTS, EMILY KALYN GRACE
Entity type:Individual
Prefix:
First Name:EMILY
Middle Name:KALYN GRACE
Last Name:ROBERTS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5707 KY ROUTE 3379
Mailing Address - Street 2:
Mailing Address - City:HAROLD
Mailing Address - State:KY
Mailing Address - Zip Code:41635-8983
Mailing Address - Country:US
Mailing Address - Phone:606-791-5080
Mailing Address - Fax:
Practice Address - Street 1:5707 KY ROUTE 3379
Practice Address - Street 2:
Practice Address - City:HAROLD
Practice Address - State:KY
Practice Address - Zip Code:41635-8983
Practice Address - Country:US
Practice Address - Phone:606-791-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-01
Last Update Date:2025-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program