Provider Demographics
NPI:1013661214
Name:TIGHE, ROBIN SHEPHERD (APRN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:SHEPHERD
Last Name:TIGHE
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 1:1909 BEACH BLVD STE 102
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:FL
Mailing Address - Zip Code:32250-2643
Mailing Address - Country:US
Mailing Address - Phone:904-246-2752
Mailing Address - Fax:904-246-2758
Practice Address - Street 1:1909 BEACH BLVD STE 102
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:FL
Practice Address - Zip Code:32250-2643
Practice Address - Country:US
Practice Address - Phone:904-246-2752
Practice Address - Fax:904-246-2758
Is Sole Proprietor?:No
Enumeration Date:2022-02-07
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11016663363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily