Provider Demographics
NPI:1053099168
Name:ROBERTS, CHEYNE ANDREW (APRN)
Entity type:Individual
Prefix:MR
First Name:CHEYNE
Middle Name:ANDREW
Last Name:ROBERTS
Suffix:
Gender:M
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2382 CRAWFORDVILLE HWY STE C
Mailing Address - Street 2:
Mailing Address - City:CRAWFORDVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32327-1091
Mailing Address - Country:US
Mailing Address - Phone:850-926-6363
Mailing Address - Fax:
Practice Address - Street 1:2382 CRAWFORDVILLE HWY STE C
Practice Address - Street 2:
Practice Address - City:CRAWFORDVILLE
Practice Address - State:FL
Practice Address - Zip Code:32327-1091
Practice Address - Country:US
Practice Address - Phone:850-926-6363
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-10
Last Update Date:2023-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLAPRN11027376363LA2100X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care