Basic Information
Provider Information
NPI: 1730668559
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBINSON
FirstName: JESSICA
MiddleName: MICHEL
NamePrefix:  
NameSuffix:  
Credential: RN
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 110 CYPRESS STATION DR STE 270
Address2:  
City: HOUSTON
State: TX
PostalCode: 770901639
CountryCode: US
TelephoneNumber: 8322531188
FaxNumber:  
Practice Location
Address1: 110 CYPRESS STATION DR STE 270
Address2:  
City: HOUSTON
State: TX
PostalCode: 770901639
CountryCode: US
TelephoneNumber: 8322531188
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/13/2018
LastUpdateDate: 08/13/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000X873190TXY Nursing Service ProvidersRegistered Nurse 

No ID Information.


Home