Healthcare Provider Details

I. General information

NPI: 1396348975
Provider Name (Legal Business Name): KRYSTLE ROBINSON FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KRYSTLE NASHAE ROBINSON FNP

II. Dates (important events)

Enumeration Date: 11/17/2020
Last Update Date: 04/10/2026
Certification Date: 04/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 MEDICAL CIR
WEST COLUMBIA SC
29169-3642
US

IV. Provider business mailing address

110 MEDICAL CIR
WEST COLUMBIA SC
29169-3642
US

V. Phone/Fax

Practice location:
  • Phone: 803-509-7316
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number24456
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: