Provider Demographics
NPI:1417942848
Name:SEVERANCE, ROBIN B (APN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:B
Last Name:SEVERANCE
Suffix:
Gender:F
Credentials:APN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 22ND AVE N
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37203-1870
Mailing Address - Country:US
Mailing Address - Phone:629-255-3486
Mailing Address - Fax:629-255-3075
Practice Address - Street 1:222 22ND AVE N
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203-1852
Practice Address - Country:US
Practice Address - Phone:629-255-2247
Practice Address - Fax:629-255-4191
Is Sole Proprietor?:No
Enumeration Date:2005-09-12
Last Update Date:2021-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN93848363LA2100X
TN6735363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN6735OtherAPN LICENSE
TN3909731Medicare ID - Type Unspecified
TN3909731Medicaid