Provider Demographics
NPI:1003008095
Name:HOUSE, ROBIN R (APRN NP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:R
Last Name:HOUSE
Suffix:
Gender:F
Credentials:APRN NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 936
Mailing Address - Street 2:
Mailing Address - City:LONDON
Mailing Address - State:KY
Mailing Address - Zip Code:40743-0936
Mailing Address - Country:US
Mailing Address - Phone:606-330-7835
Mailing Address - Fax:606-330-7825
Practice Address - Street 1:1406 W 5TH ST
Practice Address - Street 2:SUITE 201
Practice Address - City:LONDON
Practice Address - State:KY
Practice Address - Zip Code:40741-1688
Practice Address - Country:US
Practice Address - Phone:606-330-2377
Practice Address - Fax:606-330-2369
Is Sole Proprietor?:No
Enumeration Date:2007-08-14
Last Update Date:2019-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY5204P363LF0000X
KY3005204363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYP00716443OtherRR MEDICARE
KY000000609854OtherANTHEM
KY7100038230Medicaid
KYP00716443OtherRR MEDICARE