MEDICARE: KRISTY L ROBINSON FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	R866077	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003984592
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KRISTY L ROBINSON FNP

Provider Business Mailing Address
First Line	:	1668 WEST PEACE STREET
Second Line	:	P O BOX 588
City	:	CANTON
State	:	MS
Zip	:	39046
Country	:	US
Telephone Number	:	601-859-5213
Fax Number	:	601-859-8771

Provider Business Practice Location Address
First Line	:	1008 CALHOUN AVE
Second Line	:
City	:	YAZOO CITY
State	:	MS
Zip	:	39194-2938
Country	:	US
Telephone Number	:	662-751-8847
Fax Number	:	662-751-8848

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2006
Last Update Date	:	07/01/2025

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