Provider Demographics
NPI:1972084978
Name:ROBINSON, NICOLE LEE (MSN APRN FNP-C)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:LEE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:MSN APRN FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:40 SHELTON DR
Mailing Address - Street 2:
Mailing Address - City:MOREHEAD
Mailing Address - State:KY
Mailing Address - Zip Code:40351-7271
Mailing Address - Country:US
Mailing Address - Phone:859-749-8773
Mailing Address - Fax:
Practice Address - Street 1:3301 30TH AVE S STE 102
Practice Address - Street 2:
Practice Address - City:GRAND FORKS
Practice Address - State:ND
Practice Address - Zip Code:58201-6009
Practice Address - Country:US
Practice Address - Phone:877-522-1275
Practice Address - Fax:509-491-3031
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2021-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDR46703363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily