Provider Demographics
NPI:1336385335
Name:ROBINSON, CAROLYN JAN (FNP-BC)
Entity type:Individual
Prefix:
First Name:CAROLYN
Middle Name:JAN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2675 41ST ST SE STE 103
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:TX
Mailing Address - Zip Code:75462-8209
Mailing Address - Country:US
Mailing Address - Phone:903-739-7700
Mailing Address - Fax:903-739-7989
Practice Address - Street 1:2675 41ST ST SE STE 103
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:TX
Practice Address - Zip Code:75462-8209
Practice Address - Country:US
Practice Address - Phone:903-739-7700
Practice Address - Fax:903-739-7989
Is Sole Proprietor?:No
Enumeration Date:2008-12-21
Last Update Date:2024-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX691998363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXP00732181OtherINDIVIDUAL RAILROAD MEDICARE
TX002SEOtherBCBS
TX263879309OtherTAX ID
TX2054736Medicaid
TX263879309OtherTAX ID