Individual
MR. TERRY ALLEN ROBICHAUD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
10561 JEFFREYS ST STE 211, HENDERSON, NV 89052
(702) 990-4530
Mailing address
10561 JEFFREYS ST STE 211, HENDERSON, NV 89052-4268
(702) 990-4530
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
444
NV
363AM0700X
Medical Physician Assistant
444
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100510539
—
NV
05
—
1881644771
—
NV
Enumeration date
05/11/2006
Last updated
05/21/2018
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