NPI 1629546072
Andre Roberson
Practice location
- Address
- 1110 Evergreen Ln N, Plymouth, MN 55441-4834
- Phone
- (763) 200-7441
Registered specialties
Adult Companion
Primary
Registry record
- NPI
- 1629546072
- Entity type
- Individual
- Sex (as registered)
- Male
- NPI issued
- 4 Nov 2018
- Record last updated
- 4 Nov 2018
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.