MEDICARE: DR. LESLIE KAYE ROBBINS PHD, CNP, CNS

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	363LP0808X	Psychiatric/Mental Health Nurse Practitioner	R29079	NM
2	364SP0808X	Psychiatric/Mental Health Clinical Nurse Specialist	R29079	NM

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1972714418	OTHER	NM	BLUE CROSS BLUE SHIELD

General Provider Information

NPI Number	:	1972714418
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. LESLIE KAYE ROBBINS PHD, CNP, CNS

Provider Business Mailing Address
First Line	:	3317 SOLARRIDGE ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7797
Country	:	US
Telephone Number	:	575-382-0659
Fax Number	:

Provider Business Practice Location Address
First Line	:	3317 SOLARRIDGE ST
Second Line	:
City	:	LAS CRUCES
State	:	NM
Zip	:	88012-7797
Country	:	US
Telephone Number	:	575-382-0659
Fax Number	:

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

Provider Enumeration Date	:	05/25/2007
Last Update Date	:	02/04/2009

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