Provider Demographics
NPI:1265799977
Name:ROBIN, KERRI DRAKE (FNP-BC)
Entity type:Individual
Prefix:MRS
First Name:KERRI
Middle Name:DRAKE
Last Name:ROBIN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4433 LEISURE TIME DR
Mailing Address - Street 2:
Mailing Address - City:DIAMONDHEAD
Mailing Address - State:MS
Mailing Address - Zip Code:39525-3259
Mailing Address - Country:US
Mailing Address - Phone:228-586-9229
Mailing Address - Fax:228-586-9230
Practice Address - Street 1:4433 LEISURE TIME DR
Practice Address - Street 2:
Practice Address - City:DIAMONDHEAD
Practice Address - State:MS
Practice Address - Zip Code:39525-3259
Practice Address - Country:US
Practice Address - Phone:228-586-9229
Practice Address - Fax:228-586-9230
Is Sole Proprietor?:No
Enumeration Date:2012-04-19
Last Update Date:2012-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSR866047363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily