Provider Demographics
NPI:1184628612
Name:ROBBINS, MELISSA A (FNP)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:A
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 BAUM DR
Mailing Address - Street 2:SUITE 140
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37919-7360
Mailing Address - Country:US
Mailing Address - Phone:865-584-5727
Mailing Address - Fax:865-450-9904
Practice Address - Street 1:2428 KNOB CREEK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-2397
Practice Address - Country:US
Practice Address - Phone:423-794-1074
Practice Address - Fax:423-794-1079
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2014-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNAPN7933363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3901269Medicaid
TN4007281OtherBCBST
500017160Medicare PIN
TN3901269Medicaid
P27470Medicare UPIN
3703865Medicare PIN
TN103I500636Medicare PIN
3901261Medicare PIN