NPI 1003119538

Shayla R Robertson, IDC

Practitioner Independent Duty Corpsman Norfolk, VA

Practice location

Address: 150 Allen St, Norfolk, VA 23505-1373
Phone: (850) 497-6656

Registered specialties

Independent Duty Corpsman Primary

Other Service Providers Taxonomy 1710I1002X Licence RV013614 (OH)

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Registry record

NPI: 1003119538
Entity type: Individual
Sex (as registered): Female
NPI issued: 5 Dec 2010
Record last updated: 5 Dec 2010

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.