Provider Demographics
NPI:1952888083
Name:ROBINSON, ELIZABETH WAMBOI
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:WAMBOI
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:906 STILLHOUSE SPG
Mailing Address - Street 2:
Mailing Address - City:ROUND ROCK
Mailing Address - State:TX
Mailing Address - Zip Code:78681-2529
Mailing Address - Country:US
Mailing Address - Phone:704-287-0621
Mailing Address - Fax:
Practice Address - Street 1:3705 LEAFIELD DR
Practice Address - Street 2:
Practice Address - City:AUSTIN
Practice Address - State:TX
Practice Address - Zip Code:78749-3221
Practice Address - Country:US
Practice Address - Phone:512-786-7650
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-21
Last Update Date:2018-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX333089164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse