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General NPI Number Information
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NPI Number | 1336658970
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Entity Type | Individual
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Provider Name | NIKKITA SHANEE ROBINSON CRNA
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Gender | Female
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Dates
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Enumeration Date | 09/27/2017
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Last Update Date | 09/27/2017
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Provider Practice Location Address
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Address Line | 7601 SOUTHCREST PKWY
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City | SOUTHAVEN
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State | MS
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Zip | 38671-4739
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Country | US
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Telephone | 662-772-4333
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Fax | 855-999-1345
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Provider Business Mailing Address
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Address Line | 7956 VAUGHN RD # 165
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City | MONTGOMERY
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State | AL
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Zip | 36116-6625
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Country | US
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Telephone | 888-233-1493
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Fax | 855-999-1345
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | ROBI-5WT8H4
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License Number State | MS
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