Basic Information
Provider Information
NPI: 1841518891
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: ROBERSON
FirstName: LUANN
MiddleName:  
NamePrefix: MS.
NameSuffix:  
Credential: RN, BSN, CBPN-I,C
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 9700 N 91ST ST
Address2: STE C-200
City: SCOTTSDALE
State: AZ
PostalCode: 852585054
CountryCode: US
TelephoneNumber: 4804255000
FaxNumber: 4804255010
Practice Location
Address1: 9220 E MOUNTAIN VIEW RD
Address2: STE. 100
City: SCOTTSDALE
State: AZ
PostalCode: 852585133
CountryCode: US
TelephoneNumber: 4804255000
FaxNumber: 4804255010
Other Information
ProviderEnumerationDate: 05/13/2010
LastUpdateDate: 05/13/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN041360AZY Nursing Service ProvidersRegistered Nurse 
163WW0101XRN041360AZN Nursing Service ProvidersRegistered NurseWomen's Health Care, Ambulatory

No ID Information.


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