Provider Demographics
NPI:1205020625
Name:ROBINSON, BETH ANNE (NP-C)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:ANNE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANNE
Other - Last Name:LASKOWSKI
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:6300 RIVERSIDE PLAZA LN NW STE 118
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87120-2617
Mailing Address - Country:US
Mailing Address - Phone:434-989-9571
Mailing Address - Fax:
Practice Address - Street 1:6300 RIVERSIDE PLAZA LN NW STE 118
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87120-2617
Practice Address - Country:US
Practice Address - Phone:434-989-9571
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-29
Last Update Date:2019-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024169799363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily