1669464863 NPI number — MRS. APRIL DENHAM ROBBINS CFNP

Table of content: MRS. APRIL DENHAM ROBBINS CFNP (NPI 1669464863)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669464863 NPI number — MRS. APRIL DENHAM ROBBINS CFNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBBINS
Provider First Name:
APRIL
Provider Middle Name:
DENHAM
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CFNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DENHAM
Provider Other First Name:
APRIL
Provider Other Middle Name:
ELIZABETH
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
FNP
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669464863
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/09/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
15921 BOUNDARY DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ASHLAND
Provider Business Mailing Address State Name:
MS
Provider Business Mailing Address Postal Code:
38603-7740
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
662-566-5593
Provider Business Mailing Address Fax Number:
662-566-4419

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1561 HWY 30 WEST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MYRTLE
Provider Business Practice Location Address State Name:
MS
Provider Business Practice Location Address Postal Code:
38650
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
662-534-0033
Provider Business Practice Location Address Fax Number:
662-539-0039
Provider Enumeration Date:
08/16/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  R860041 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363LF0000X , with the licence number: R860041 , registered in the state of MS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 202374443 . This is a "CHAMPUS" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 202374443 . This is a "AETNA" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 202374443 . This is a "CIGNA" identifier , issued by the state of ( MS ) . This identifiers is of the category "OTHER".
  • Identifier: 03156350 , issued by the state of ( MS ) . This identifiers is of the category "MEDICAID".




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