Provider Demographics
NPI:1154991255
Name:ROBINSON, KELLYANN (CRNA)
Entity type:Individual
Prefix:
First Name:KELLYANN
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13430 LANDON WAY
Mailing Address - Street 2:
Mailing Address - City:SAINT HEDWIG
Mailing Address - State:TX
Mailing Address - Zip Code:78152-0390
Mailing Address - Country:US
Mailing Address - Phone:321-262-3044
Mailing Address - Fax:
Practice Address - Street 1:13430 LANDON WAY
Practice Address - Street 2:
Practice Address - City:SAINT HEDWIG
Practice Address - State:TX
Practice Address - Zip Code:78152-0390
Practice Address - Country:US
Practice Address - Phone:321-262-3044
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-30
Last Update Date:2024-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1090614367500000X
FLAPRN11018251207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered