Healthcare Provider Details

I. General information

NPI: 1447545645
Provider Name (Legal Business Name): KRISTEN LYN ROBINSON PMHNP, FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/15/2011
Last Update Date: 08/02/2024
Certification Date: 08/02/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

202 E EARLL DR SUITE 200
PHOENIX AZ
85012-2634
US

IV. Provider business mailing address

2754 S HERITAGE DR
GILBERT AZ
85295-7165
US

V. Phone/Fax

Practice location:
  • Phone: 602-808-2800
  • Fax: 602-808-2799
Mailing address:
  • Phone: 704-840-5623
  • Fax: --

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberAP4084
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAP8992
License Number StateAZ
# 3
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number5019414
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: