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NPI Code Detail

MEDICARE: NEYSA JAYDE ROBINSON PA

MEDICARE: NEYSA JAYDE ROBINSON PA
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
1171M00000XCase Manager/Care Coordinator
2364SP0808XPsychiatric/Mental Health Clinical Nurse SpecialistPA-1695ID
3363A00000XPhysician AssistantPA-1695ID

General Provider Information

NPI Number : 1457854515
Entity Type Code : Individual
Provider Name (Legal Business Name) : NEYSA JAYDE ROBINSON PA
Provider Business Mailing Address
First Line : PO BOX 9
Second Line :
City : NAMPA
State : ID
Zip : 83653-0009
Country : US
Telephone Number : 208-467-4431
Fax Number : 208-466-5359
Provider Business Practice Location Address
First Line : 808 CLEVELAND BLVD
Second Line :
City : CALDWELL
State : ID
Zip : 83605-4168
Country : US
Telephone Number : 208-459-1025
Fax Number : 208-459-1080
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/15/2018
Last Update Date : 11/27/2023

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Directions to “ NEYSA JAYDE ROBINSON PA” Practice Location

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