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NPI Code Detail

MEDICARE: LARISSA ROBINSON CRNP

MEDICARE: LARISSA ROBINSON CRNP
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
1363L00000XNurse Practitioner1116478AL
2363LP2300XPrimary Care Nurse Practitioner1116478AL

Other Identifiers

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

General Provider Information

NPI Number : 1013282987
Entity Type Code : Individual
Provider Name (Legal Business Name) : LARISSA ROBINSON CRNP
Provider Business Mailing Address
First Line : PO BOX 1571
Second Line :
City : JASPER
State : AL
Zip : 35502-1571
Country : US
Telephone Number : 205-221-9351
Fax Number : 205-221-3700
Provider Business Practice Location Address
First Line : 2201 N AIRPORT RD
Second Line :
City : JASPER
State : AL
Zip : 35504-7058
Country : US
Telephone Number : 205-221-9351
Fax Number : 205-221-3700
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/12/2012
Last Update Date : 12/19/2025

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