| Angela Olivia Roberts, Aprn, Llc | |
| 427 Naubuc Ave Ste 101 Glastonbury CT 06033-1082 | |
| (959) 207-1951 | |
| (888) 845-1141 | 
| Full Name | Angela Olivia Roberts, Aprn, Llc | 
|---|---|
| Speciality | Clinic/Center | 
| Location | 427 Naubuc Ave Ste 101, Glastonbury, Connecticut | 
| Authorized Official Name and Position | Angela Olivia Roberts (MANAGING MEMBER) | 
| Authorized Official Contact | 9592071951 | 
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. | 
| Mailing Address | Practice Location Address | 
|---|---|
| Angela Olivia Roberts, Aprn, Llc 3021 Main St Rocky Hill CT 06067-3765 Ph: (860) 256-9367 | Angela Olivia Roberts, Aprn, Llc 427 Naubuc Ave Ste 101 Glastonbury CT 06033-1082 Ph: (959) 207-1951 | 
| NPI Number | 1841816956 | 
|---|---|
| Provider Enumeration Date | 06/24/2020 | 
| Last Update Date | 06/24/2020 | 
| Certification Date | 06/24/2020 | 
| Medicare PECOS PAC ID | 9335550599 | 
|---|---|
| Medicare Enrollment ID | O20201119003078 | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1841816956 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 261QM0850X | Clinic/center - Adult Mental Health | (* (Not Available)) | Primary | 
| Provider Name | Angela O Roberts | 
|---|---|
| Provider Type | Practitioner - Nurse Practitioner | 
| Provider Identifiers | NPI Number: 1477092773 PECOS PAC ID: 0143506923 Enrollment ID: I20170410001453 | 
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