Basic Information
Provider Information | |||||||||
NPI: | 1851586473 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | ROBBINS | ||||||||
FirstName: | LINZEY | ||||||||
MiddleName: | M | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | PNP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 1108 REDLEAF DR | ||||||||
Address2: |   | ||||||||
City: | NOLANVILLE | ||||||||
State: | TX | ||||||||
PostalCode: | 765594653 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2102699905 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 17323 IH 35 N | ||||||||
Address2: | SUITE 113 | ||||||||
City: | SCHERTZ | ||||||||
State: | TX | ||||||||
PostalCode: | 781541277 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 2106564878 | ||||||||
FaxNumber: | 2107450562 | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 09/06/2007 | ||||||||
LastUpdateDate: | 09/15/2008 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LP0200X | 676476 | TX | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Pediatrics |
ID Information
ID | Type | State | Issuer | Description | 363LP0200X | 01 |   | NURSE PRACTITIONER/ PEDIATRICS | OTHER |