MEDICARE: TERESA EVETTE ROBINSON PMHNP-BC

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	163WM0102X	Maternal Newborn Registered Nurse	253037	AZ
2	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	253037	AZ

General Provider Information

NPI Number	:	1649140922
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TERESA EVETTE ROBINSON PMHNP-BC

Provider Business Mailing Address
First Line	:	24871 S ELLSWORTH RD STE 100-162
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-1574
Country	:	US
Telephone Number	:	480-269-4106
Fax Number	:

Provider Business Practice Location Address
First Line	:	24871 S ELLSWORTH RD STE 100-162
Second Line	:
City	:	QUEEN CREEK
State	:	AZ
Zip	:	85142-1574
Country	:	US
Telephone Number	:	480-269-4106
Fax Number	:

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

Provider Enumeration Date	:	11/11/2025
Last Update Date	:	03/12/2026

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