Provider Demographics
NPI:1356039614
Name:ROBINSON, NELDA SUE (RN)
Entity type:Individual
Prefix:MRS
First Name:NELDA
Middle Name:SUE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5833 SYCAMORE CREEK RD
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76134-1918
Mailing Address - Country:US
Mailing Address - Phone:682-380-0508
Mailing Address - Fax:
Practice Address - Street 1:5833 SYCAMORE CREEK RD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76134-1918
Practice Address - Country:US
Practice Address - Phone:682-380-0508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-25
Last Update Date:2023-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX574030163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management