Provider Demographics
NPI:1093085268
Name:OTTE, ROBIN GRIMES (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:GRIMES
Last Name:OTTE
Suffix:
Gender:F
Credentials:MSN, CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1751 VETERANS DR STE 125
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:AL
Mailing Address - Zip Code:35630-4932
Mailing Address - Country:US
Mailing Address - Phone:256-766-0150
Mailing Address - Fax:256-764-4638
Practice Address - Street 1:1751 VETERANS DR STE 125
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:AL
Practice Address - Zip Code:35630-4932
Practice Address - Country:US
Practice Address - Phone:256-766-0150
Practice Address - Fax:256-764-4638
Is Sole Proprietor?:No
Enumeration Date:2012-01-05
Last Update Date:2020-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-113617363LX0001X
AL1113617363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology