Provider Demographics
NPI:1396464194
Name:CONNORS, ROBIN ARIME (PMHNP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ARIME
Last Name:CONNORS
Suffix:
Gender:F
Credentials:PMHNP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:MARIE
Other - Last Name:FERZELY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3600 S NATIONAL AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65807-7311
Mailing Address - Country:US
Mailing Address - Phone:417-322-6622
Mailing Address - Fax:417-350-1935
Practice Address - Street 1:1331 N TEXAS AVE APT C
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65802-2073
Practice Address - Country:US
Practice Address - Phone:417-322-6622
Practice Address - Fax:417-350-1935
Is Sole Proprietor?:No
Enumeration Date:2022-08-24
Last Update Date:2025-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2022040256363LP0808X
AR222135363LP0808X
KS53-83650-032363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO420115990Medicaid
AR293245758Medicaid