Provider Demographics
NPI:1467296319
Name:ROBLES, EVELYNN PETRA (FNP-C)
Entity type:Individual
Prefix:
First Name:EVELYNN
Middle Name:PETRA
Last Name:ROBLES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22601 N 19TH AVE STE 230
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85027-1362
Mailing Address - Country:US
Mailing Address - Phone:602-567-9953
Mailing Address - Fax:
Practice Address - Street 1:22601 N 19TH AVE STE 230
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85027-1362
Practice Address - Country:US
Practice Address - Phone:602-567-9953
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-24
Last Update Date:2024-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ226727363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner