Healthcare Provider Details

I. General information

NPI: 1366906646
Provider Name (Legal Business Name): ROXANNA LILY ROBBINS MS APRN AGACNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2019
Last Update Date: 08/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 SEYMOUR ST
HARTFORD CT
06102-8000
US

IV. Provider business mailing address

85 SEYMOUR ST STE 725
HARTFORD CT
06106-5501
US

V. Phone/Fax

Practice location:
  • Phone: 860-972-3526
  • Fax:
Mailing address:
  • Phone: 860-972-3526
  • Fax: 860-545-3184

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number7331
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number7331
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: