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General NPI Number Information
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NPI Number | 1649536947
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Entity Type | Individual
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Provider Name | TIMOTHY R ROBINSON ACNP
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Gender | Male
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Dates
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Enumeration Date | 04/11/2012
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Last Update Date | 04/11/2012
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Provider Practice Location Address
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Address Line | 3101 DENNY AVE SUITE 240
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City | PASCAGOULA
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State | MS
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Zip | 39581-5307
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Country | US
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Telephone | 228-769-0276
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Fax |
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Provider Business Mailing Address
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Address Line | 22506 SONORA DR
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City | MOSS POINT
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State | MS
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Zip | 39562-6451
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Country | US
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Telephone | 228-588-0867
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Fax |
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | R859435
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License Number State | MS
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