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General NPI Number Information
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NPI Number | 1740893841
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Entity Type | Individual
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Provider Name | KRISTA IVANA ROBINSON
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Gender | Female
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Dates
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Enumeration Date | 08/28/2020
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Last Update Date | 08/03/2021
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Provider Practice Location Address
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Address Line | 5466 THOMASVILLE RD
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City | TALLAHASSEE
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State | FL
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Zip | 32312-3812
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Country | US
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Telephone | 850-893-8116
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Fax |
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Provider Business Mailing Address
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Address Line | 5995 ARCH AVE
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City | PENSACOLA
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State | FL
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Zip | 32526-3232
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Country | US
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Telephone | 478-318-5910
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 11007262
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License Number State | FL
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