Provider Demographics
NPI:1477966034
Name:KATHLEEN ROBLYER APRN PMHNP LLC
Entity Type:Organization
Organization Name:KATHLEEN ROBLYER APRN PMHNP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PMHNP
Authorized Official - Prefix:DR
Authorized Official - First Name:KATHLEEN
Authorized Official - Middle Name:AC
Authorized Official - Last Name:ROBLYER
Authorized Official - Suffix:
Authorized Official - Credentials:DMIN MSN APRN PMHNP
Authorized Official - Phone:979-693-0854
Mailing Address - Street 1:2151 HARVEY MITCHELL PKWY S
Mailing Address - Street 2:SUITE 113
Mailing Address - City:COLLEGE STATION
Mailing Address - State:TX
Mailing Address - Zip Code:77840-5281
Mailing Address - Country:US
Mailing Address - Phone:979-693-0854
Mailing Address - Fax:979-693-0863
Practice Address - Street 1:2151 HARVEY MITCHELL PKWY S
Practice Address - Street 2:SUITE 113
Practice Address - City:COLLEGE STATION
Practice Address - State:TX
Practice Address - Zip Code:77840-5281
Practice Address - Country:US
Practice Address - Phone:979-693-0854
Practice Address - Fax:979-693-0863
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-06-11
Last Update Date:2014-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP120293363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental HealthGroup - Single Specialty