Provider Demographics
NPI:1710948005
Name:LANDGRAF, ROBIN LEIGH (RN CPNP-PC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEIGH
Last Name:LANDGRAF
Suffix:
Gender:F
Credentials:RN CPNP-PC
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:LEIGH
Other - Last Name:WOODALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN CPNP-PC
Mailing Address - Street 1:1935 MEDICAL DISTRICT DR
Mailing Address - Street 2:
Mailing Address - City:DALLAS
Mailing Address - State:TX
Mailing Address - Zip Code:75235-7701
Mailing Address - Country:US
Mailing Address - Phone:214-456-8000
Mailing Address - Fax:214-456-8005
Practice Address - Street 1:1935 MEDICAL DISTRICT DR
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75235-7701
Practice Address - Country:US
Practice Address - Phone:214-456-8000
Practice Address - Fax:214-456-8005
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2009-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX568802363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX177193301Medicaid
TX8G0909Medicare ID - Type Unspecified
TX177193301Medicaid