Provider Demographics
NPI:1184455370
Name:ROBLES, KATHRYN M (FNP-C)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:M
Last Name:ROBLES
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 VANOVER LN
Mailing Address - Street 2:
Mailing Address - City:JACKSBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37757-4359
Mailing Address - Country:US
Mailing Address - Phone:661-904-9016
Mailing Address - Fax:
Practice Address - Street 1:120 CENTER PARK DR STE 6
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37922-2117
Practice Address - Country:US
Practice Address - Phone:865-288-4115
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-08-09
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN36822363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care