Healthcare Provider Details

I. General information

NPI: 1366195083
Provider Name (Legal Business Name): KATHY DIANE ROBISON APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/02/2022
Last Update Date: 02/09/2022
Certification Date: 02/09/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

760 BLACKWEASEL RD.
BROWNING MT
59417
US

IV. Provider business mailing address

PO BOX 1557
BROWNING MT
59417-1557
US

V. Phone/Fax

Practice location:
  • Phone: 406-338-6100
  • Fax:
Mailing address:
  • Phone: 479-461-0817
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number191988
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: