Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | CNP-01574 | NM |
Y | 363LP0808X | Nurse Practitioner - Psychiatric/Mental Health | RN052408-APO5977 | LA |
NPI | 1033440391 |
---|---|
Provider Name | Ms. Jeanene Toombs Robb |
First Address | Independence, LA 70443-0130 |
Second Address | Independence, LA 70443-2386 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/01/2010 |
Last Update Date | 29/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2120280 | (05) | LA |