Provider Demographics
NPI:1407281553
Name:HUCKABY, ROBYN (ARNP)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:HUCKABY
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5452 S 171ST ST W
Mailing Address - Street 2:
Mailing Address - City:GODDARD
Mailing Address - State:KS
Mailing Address - Zip Code:67052-8249
Mailing Address - Country:US
Mailing Address - Phone:316-253-0207
Mailing Address - Fax:
Practice Address - Street 1:1131 S CLIFTON AVE STE B
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-2963
Practice Address - Country:US
Practice Address - Phone:316-462-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-09
Last Update Date:2013-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-76096-081363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily