Provider Demographics
NPI:1386047157
Name:DESVAUX, ROBIN SIKES (FNP-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:SIKES
Last Name:DESVAUX
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:PHELPS
Other - Last Name:SIKES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-C
Mailing Address - Street 1:PO BOX 60447
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28260-0447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:215 S MAIN ST
Practice Address - Street 2:
Practice Address - City:MT HOLLY
Practice Address - State:NC
Practice Address - Zip Code:28120-1620
Practice Address - Country:US
Practice Address - Phone:704-587-2401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-10-07
Last Update Date:2024-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5007242363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily