Healthcare Provider Details

I. General information

NPI: 1053638817
Provider Name (Legal Business Name): BOBBI JEAN ROBBINS ANP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2010
Last Update Date: 12/27/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 HIGHWAY 16
DEER AR
72628
US

IV. Provider business mailing address

PO BOX 1060
MARSHALL AR
72650-1060
US

V. Phone/Fax

Practice location:
  • Phone: 870-428-5391
  • Fax: 870-428-5392
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA03352ANP
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: