Healthcare Provider Details

I. General information

NPI: 1417754094
Provider Name (Legal Business Name): JESSY ROBBINS MS PHD LMT
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/28/2025
Last Update Date: 02/28/2025
Certification Date: 02/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 N 7TH ST
VINCENNES IN
47591-3107
US

IV. Provider business mailing address

6405 S LAFFERTY RD
VINCENNES IN
47591-9103
US

V. Phone/Fax

Practice location:
  • Phone: 812-255-0277
  • Fax:
Mailing address:
  • Phone: 812-910-0583
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMT22308160
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: