Provider Demographics
NPI:1891730891
Name:ROBBINS, CONNIE LYNN (CRNP)
Entity Type:Individual
Prefix:
First Name:CONNIE
Middle Name:LYNN
Last Name:ROBBINS
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2190
Mailing Address - Street 2:3701 LOOP RD EAST BLDG 39
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35403
Mailing Address - Country:US
Mailing Address - Phone:205-562-3700
Mailing Address - Fax:205-562-3769
Practice Address - Street 1:3701 LOOP RD EAST
Practice Address - Street 2:BLDG 39
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35404
Practice Address - Country:US
Practice Address - Phone:205-562-3700
Practice Address - Fax:205-562-3769
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1041031363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51518232OtherBCBS OF AL
P36080Medicare UPIN
AL51554039Medicare ID - Type Unspecified