Provider Demographics
NPI:1073106191
Name:DONALDSON, ROBIN MICHELLE (NP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:MICHELLE
Last Name:DONALDSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11155 DUNN RD STE 201N
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63136-6149
Mailing Address - Country:US
Mailing Address - Phone:314-741-1400
Mailing Address - Fax:314-741-0175
Practice Address - Street 1:11155 DUNN RD STE 201N
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63136-6149
Practice Address - Country:US
Practice Address - Phone:314-741-1400
Practice Address - Fax:314-741-0175
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-19
Last Update Date:2021-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2020035581363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner