MEDICARE: JAMES ROBB FNP-C

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	363L00000X	Nurse Practitioner	75401	NM

General Provider Information

NPI Number	:	1801671631
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ROBB FNP-C

Provider Business Mailing Address
First Line	:	7300 RANCH ROAD 2222 STE 200
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78730-3204
Country	:	US
Telephone Number	:	512-628-0465
Fax Number	:

Provider Business Practice Location Address
First Line	:	5512 E MAIN ST STE A
Second Line	:
City	:	FARMINGTON
State	:	NM
Zip	:	87402-4421
Country	:	US
Telephone Number	:	505-787-2515
Fax Number	:

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

Provider Enumeration Date	:	08/29/2023
Last Update Date	:	08/29/2023

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