Provider Demographics
NPI:1831657220
Name:PLEDGER, ROBBIE KATHERINE
Entity Type:Individual
Prefix:
First Name:ROBBIE
Middle Name:KATHERINE
Last Name:PLEDGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:817 N 44TH ST
Mailing Address - Street 2:
Mailing Address - City:WACO
Mailing Address - State:TX
Mailing Address - Zip Code:76710-4939
Mailing Address - Country:US
Mailing Address - Phone:254-498-0423
Mailing Address - Fax:
Practice Address - Street 1:817 N 44TH ST APT 1801
Practice Address - Street 2:
Practice Address - City:WACO
Practice Address - State:TX
Practice Address - Zip Code:76710-4939
Practice Address - Country:US
Practice Address - Phone:254-498-0423
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-03-05
Last Update Date:2019-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX306209164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse