Provider Demographics
NPI:1124034988
Name:LUFFY, ROBIN (RNCPNP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:
Last Name:LUFFY
Suffix:
Gender:F
Credentials:RNCPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR
Mailing Address - Street 2:PAVILION BLDG, MAIL F5.07
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:214-456-2853
Mailing Address - Fax:214-456-5406
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:PAVILION BLDG, MAIL F5.07
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-2853
Practice Address - Fax:214-456-5406
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2008-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX434979363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX141413801Medicaid