Provider Demographics
NPI:1053638817
Name:ROBBINS, BOBBI JEAN (ANP)
Entity Type:Individual
Prefix:
First Name:BOBBI
Middle Name:JEAN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:ANP
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 1060
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:AR
Mailing Address - Zip Code:72650-1060
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1 HIGHWAY 16
Practice Address - Street 2:
Practice Address - City:DEER
Practice Address - State:AR
Practice Address - Zip Code:72628
Practice Address - Country:US
Practice Address - Phone:870-428-5391
Practice Address - Fax:870-428-5392
Is Sole Proprietor?:No
Enumeration Date:2010-05-03
Last Update Date:2011-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA03352ANP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR189021758Medicaid
AR5V640OtherMEDICARE PTAN