Provider Demographics
NPI:1821756990
Name:JOHNSON, ROBIN R (RN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:R
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:ROBIN
Other - Middle Name:R
Other - Last Name:JOHNSON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:159 LONGLEAF CIR
Mailing Address - Street 2:
Mailing Address - City:DESOTO
Mailing Address - State:TX
Mailing Address - Zip Code:75115-7541
Mailing Address - Country:US
Mailing Address - Phone:214-354-5277
Mailing Address - Fax:678-937-8317
Practice Address - Street 1:1391 NW 136TH AVE
Practice Address - Street 2:
Practice Address - City:SUNRISE
Practice Address - State:FL
Practice Address - Zip Code:33323-2800
Practice Address - Country:US
Practice Address - Phone:214-354-5277
Practice Address - Fax:678-937-8317
Is Sole Proprietor?:No
Enumeration Date:2021-12-06
Last Update Date:2021-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX638499163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management