Provider Demographics
NPI:1295134625
Name:EVERSON, ROBYN
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:EVERSON
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 1:400 NATURAL RESOURCES DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-1501
Mailing Address - Country:US
Mailing Address - Phone:501-687-2000
Mailing Address - Fax:501-687-1999
Practice Address - Street 1:400 NATURAL RESOURCES DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-1501
Practice Address - Country:US
Practice Address - Phone:501-687-2000
Practice Address - Fax:501-687-1999
Is Sole Proprietor?:Yes
Enumeration Date:2014-08-21
Last Update Date:2014-08-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARPT 3766225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist