Provider Demographics
NPI:1740529155
Name:WILLIAMS, ROBYN RENEE (NP)
Entity type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:RENEE
Last Name:WILLIAMS
Suffix:
Gender:F
Credentials:NP
Other - Prefix:MS
Other - First Name:ROBYN
Other - Middle Name:RENEE
Other - Last Name:KEAHEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:1920 MOORES LN STE A
Mailing Address - Street 2:
Mailing Address - City:TEXARKANA
Mailing Address - State:TX
Mailing Address - Zip Code:75503-4660
Mailing Address - Country:US
Mailing Address - Phone:903-792-8030
Mailing Address - Fax:
Practice Address - Street 1:1920 MOORES LN STE A
Practice Address - Street 2:
Practice Address - City:TEXARKANA
Practice Address - State:TX
Practice Address - Zip Code:75503-4660
Practice Address - Country:US
Practice Address - Phone:903-792-8030
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-02-05
Last Update Date:2018-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARF0113115363L00000X
TX2256363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner