Provider Demographics
NPI:1538236633
Name:ROBIE, JESSICA GIBSON (FNP-BC)
Entity type:Individual
Prefix:
First Name:JESSICA
Middle Name:GIBSON
Last Name:ROBIE
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 ONEIL ST
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-3510
Mailing Address - Country:US
Mailing Address - Phone:845-340-9506
Mailing Address - Fax:845-340-9509
Practice Address - Street 1:70 ONEIL ST
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-3510
Practice Address - Country:US
Practice Address - Phone:845-340-9506
Practice Address - Fax:845-340-9509
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY719828163W00000X
NY350088363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse