Provider Demographics
NPI:1801391610
Name:ROBINSON, JADE LOY (APRN)
Entity Type:Individual
Prefix:
First Name:JADE
Middle Name:LOY
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6424 BENTON ST
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68507-1830
Mailing Address - Country:US
Mailing Address - Phone:402-366-6915
Mailing Address - Fax:
Practice Address - Street 1:3925 S 147TH ST STE 113
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68144-5576
Practice Address - Country:US
Practice Address - Phone:402-827-6710
Practice Address - Fax:402-827-6731
Is Sole Proprietor?:No
Enumeration Date:2018-03-26
Last Update Date:2018-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112427363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily