Provider Demographics
NPI:1093103152
Name:ROBINSON, JODI (APRN)
Entity type:Individual
Prefix:
First Name:JODI
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1429
Mailing Address - Street 2:
Mailing Address - City:ARDMORE
Mailing Address - State:OK
Mailing Address - Zip Code:73402-1429
Mailing Address - Country:US
Mailing Address - Phone:580-226-8310
Mailing Address - Fax:580-223-3911
Practice Address - Street 1:1119 WALNUT DR STE 2
Practice Address - Street 2:
Practice Address - City:ARDMORE
Practice Address - State:OK
Practice Address - Zip Code:73401-2360
Practice Address - Country:US
Practice Address - Phone:580-226-8310
Practice Address - Fax:580-223-3911
Is Sole Proprietor?:No
Enumeration Date:2014-12-24
Last Update Date:2025-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK81072363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily