1831566777 NPI number — MRS. SUMMER LEIGH ROBIN APRN,FNP

Table of content: MRS. SUMMER LEIGH ROBIN APRN,FNP (NPI 1831566777)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831566777 NPI number — MRS. SUMMER LEIGH ROBIN APRN,FNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ROBIN
Provider First Name:
SUMMER
Provider Middle Name:
LEIGH
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
APRN,FNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831566777
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/03/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 792
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
VIVIAN
Provider Business Mailing Address State Name:
LA
Provider Business Mailing Address Postal Code:
71082-0792
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
318-735-1800
Provider Business Mailing Address Fax Number:
318-725-4960

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5668 BARKSDALE BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BOSSIER CITY
Provider Business Practice Location Address State Name:
LA
Provider Business Practice Location Address Postal Code:
71112-8738
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
318-735-1800
Provider Business Practice Location Address Fax Number:
318-725-4960
Provider Enumeration Date:
08/26/2015

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: 363LF0000X , with the licence number:  AP08302 , registered in the state of LA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 2574817 , issued by the state of ( LA ) . This identifiers is of the category "MEDICAID".
  • Identifier: AP08302 . This is a "LICENSE" identifier , issued by the state of ( LA ) . This identifiers is of the category "OTHER".




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