Provider Demographics
NPI:1255712899
Name:ROBINSON, REAGEN NOLAN (PA-C)
Entity type:Individual
Prefix:MRS
First Name:REAGEN
Middle Name:NOLAN
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3316 LONGPORT LN
Mailing Address - Street 2:
Mailing Address - City:THOMPSONS STATION
Mailing Address - State:TN
Mailing Address - Zip Code:37179-6800
Mailing Address - Country:US
Mailing Address - Phone:225-315-5627
Mailing Address - Fax:
Practice Address - Street 1:112 E FOWLKES ST
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37064-3658
Practice Address - Country:US
Practice Address - Phone:615-295-9990
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-06-09
Last Update Date:2025-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN3268363AM0700X
LA1255712899363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant