Healthcare Provider Details

I. General information

NPI: 1871590661
Provider Name (Legal Business Name): KARYN F. ROBERTSON PA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2005
Last Update Date: 07/15/2026
Certification Date: 07/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7165 E UNIVERSITY DR STE 183
MESA AZ
85207-6415
US

IV. Provider business mailing address

7165 E UNIVERSITY DR STE 187
MESA AZ
85207-6415
US

V. Phone/Fax

Practice location:
  • Phone: 480-668-5000
  • Fax: 480-668-5065
Mailing address:
  • Phone: 480-668-5000
  • Fax: 480-428-8593

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number1339
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: