Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mallory Roberson, NP

Individual provider Gerontology Nurse Practitioner · NPI 1134661440

Mallory Roberson, NP is a Nurse Practitioner in Cullman, Alabama. Qualified in 2016, 10 years ago. Practices with Boulder Care Provider Group PA, a 109-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Alabama.

Years since qualifying
10
Licensed in
AL
In the registry since
2016
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

See every abbreviation used in this directory →

Practice location Address checks out

1701 Main Ave SW Ste E
Cullman, AL 35055-5299
Phone: (256) 531-9213
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 1-131922 (AL)

Record details

NPI number1134661440
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedNovember 17, 2016
Last updated in NPPESOctober 16, 2024
Certification dateOctober 16, 2024
Mailing address1701 Main Ave Sw, Suite E, Cullman, AL 35055-5299

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Group practice Boulder Care Provider Group Pa — 109 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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