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Individual
ROBB IVY
Active
Individual
ROBB IVY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
676342
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144526534
—
TX
05
—
280726502
—
TX
01
—
8302UB
BCBS
TX
01
—
P00933610
MEDICARE RR
TX
01
—
TIN PLUS 015
TRICARE
TX
Enumeration date
02/01/2011
Last updated
11/09/2025
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