Most Relevant Information
Provider Data
| NPI Number: | 1003580879 |
| Provider Name: | STACY ROBERTS |
| Entity Type: | Individual |
| Taxonomy Code: | 172V00000X |
| Specialty: | Community Health Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/05/2021 |
| Last Updated: | 08/05/2021 |
Provider Practice Location
174 BRIDGET RD
MARTINSBURG
WV
254047129
Practice Location Phone/Fax
| Phone: | 3048207122 |
| Fax: |
Provider Mailing Location
174 BRIDGET RD
MARTINSBURG
WV
254047129
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |