Healthcare Provider Details

I. General information

NPI: 1093164311
Provider Name (Legal Business Name): ROBBIE LEE ROBINSON ARNP
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/07/2016
Last Update Date: 03/10/2022
Certification Date: 03/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5402 MORNINGSIDE AVE STE B
SIOUX CITY IA
51106-3136
US

IV. Provider business mailing address

5402 MORNINGSIDE AVE STE B
SIOUX CITY IA
51106-3136
US

V. Phone/Fax

Practice location:
  • Phone: 712-218-3743
  • Fax:
Mailing address:
  • Phone: 712-218-3743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberH127990
License Number StateIA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberH127990
License Number StateIA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: