Provider Demographics
NPI:1609466978
Name:ROBERTSON, REGINA WALKER (FNP)
Entity Type:Individual
Prefix:
First Name:REGINA
Middle Name:WALKER
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E BELT LINE RD STE 150
Mailing Address - Street 2:
Mailing Address - City:CEDAR HILL
Mailing Address - State:TX
Mailing Address - Zip Code:75104-2424
Mailing Address - Country:US
Mailing Address - Phone:972-291-7863
Mailing Address - Fax:972-291-0942
Practice Address - Street 1:950 E BELT LINE RD STE 150
Practice Address - Street 2:
Practice Address - City:CEDAR HILL
Practice Address - State:TX
Practice Address - Zip Code:75104-2424
Practice Address - Country:US
Practice Address - Phone:972-291-7863
Practice Address - Fax:972-291-0942
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-21
Last Update Date:2022-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1019227363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily