Provider Demographics
NPI:1871749507
Name:PIERRE ROBERTSON, SHIRLEY R (MSN, RN)
Entity type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:R
Last Name:PIERRE ROBERTSON
Suffix:
Gender:F
Credentials:MSN, RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2240 PALM BEACH LAKES BLVD STE 400E
Mailing Address - Street 2:
Mailing Address - City:WEST PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33409-3410
Mailing Address - Country:US
Mailing Address - Phone:561-688-0870
Mailing Address - Fax:561-537-7161
Practice Address - Street 1:2240 PALM BEACH LAKES BLVD STE 400E
Practice Address - Street 2:
Practice Address - City:WEST PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33409-3410
Practice Address - Country:US
Practice Address - Phone:561-688-0870
Practice Address - Fax:561-537-7161
Is Sole Proprietor?:No
Enumeration Date:2008-08-13
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN1525422101YM0800X, 101YA0400X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No171M00000XOther Service ProvidersCase Manager/Care Coordinator