Healthcare Provider Details

I. General information

NPI: 1053854810
Provider Name (Legal Business Name): MEGHAN ROBINSON PNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/28/2016
Last Update Date: 02/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4351 E LOHMAN AVE STE 100
LAS CRUCES NM
88011-8258
US

IV. Provider business mailing address

5408 THORN RIDGE CIR
EL PASO TX
79932-1465
US

V. Phone/Fax

Practice location:
  • Phone: 575-532-9077
  • Fax: 575-532-9221
Mailing address:
  • Phone: 915-269-4625
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberCNP-03117
License Number StateNM
# 2
Primary TaxonomyN
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberAP132692
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: