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General NPI Number Information
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NPI Number | 1982388278
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Entity Type | Individual
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Provider Name | JACQUELINE ROBISON NP
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Gender | Female
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Dates
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Enumeration Date | 06/15/2023
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Last Update Date | 12/04/2024
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Provider Practice Location Address
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Address Line | 949 E TAFT AVE
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City | SAPULPA
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State | OK
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Zip | 74066-5728
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Country | US
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Telephone | 918-224-6079
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Fax |
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Provider Business Mailing Address
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Address Line | 400 N EDWARDS ST
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City | ENTERPRISE
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State | AL
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Zip | 36330-2584
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Country | US
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Telephone |
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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 | 1-194771
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License Number State | AL
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 220732
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License Number State | OK
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