Provider Demographics
NPI:1396023727
Name:BEHL, ROBIN LYNN (PA-C)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNN
Last Name:BEHL
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4351 E LOHMAN AVE STE 204
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88011-8260
Mailing Address - Country:US
Mailing Address - Phone:575-526-7139
Mailing Address - Fax:575-526-7852
Practice Address - Street 1:4351 E LOHMAN AVE STE 204
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88011-8260
Practice Address - Country:US
Practice Address - Phone:575-526-7139
Practice Address - Fax:575-526-7852
Is Sole Proprietor?:No
Enumeration Date:2011-08-03
Last Update Date:2017-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY017629363A00000X
MEPA001284363A00000X
NMPA2017-0022363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM21523207Medicaid