Provider Demographics
NPI:1164554077
Name:ROBERTSON, ROBBIE L (RN)
Entity Type:Individual
Prefix:
First Name:ROBBIE
Middle Name:L
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 COOL SPRING RD
Mailing Address - Street 2:
Mailing Address - City:TRIMBLE
Mailing Address - State:TN
Mailing Address - Zip Code:38259-4404
Mailing Address - Country:US
Mailing Address - Phone:731-643-6612
Mailing Address - Fax:
Practice Address - Street 1:1250 S MANUFACTURERS ROW
Practice Address - Street 2:
Practice Address - City:TRENTON
Practice Address - State:TN
Practice Address - Zip Code:38382-3632
Practice Address - Country:US
Practice Address - Phone:731-855-7601
Practice Address - Fax:731-855-7603
Is Sole Proprietor?:No
Enumeration Date:2007-03-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000101175163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse