Provider Demographics
NPI:1750587788
Name:ROBISON, KRISTINE ELIZABETH (NURSE PRACTITIONER)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:ELIZABETH
Last Name:ROBISON
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29550 WATSON RD
Mailing Address - Street 2:
Mailing Address - City:ROMOLAND
Mailing Address - State:CA
Mailing Address - Zip Code:92585-9141
Mailing Address - Country:US
Mailing Address - Phone:909-928-8540
Mailing Address - Fax:
Practice Address - Street 1:4445 MAGNOLIA AVE
Practice Address - Street 2:
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4135
Practice Address - Country:US
Practice Address - Phone:951-788-3570
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-06-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA17224363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal