Healthcare Provider Details

I. General information

NPI: 1003984592
Provider Name (Legal Business Name): KRISTY L ROBINSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/01/2006
Last Update Date: 07/01/2025
Certification Date: 07/01/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1008 CALHOUN AVE
YAZOO CITY MS
39194-2938
US

IV. Provider business mailing address

1668 WEST PEACE STREET P O BOX 588
CANTON MS
39046
US

V. Phone/Fax

Practice location:
  • Phone: 662-751-8847
  • Fax: 662-751-8848
Mailing address:
  • Phone: 601-859-5213
  • Fax: 601-859-8771

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR866077
License Number StateMS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: