Provider Demographics
NPI:1114279197
Name:MANN, ROBBIN LYNNE (ARNP)
Entity Type:Individual
Prefix:
First Name:ROBBIN
Middle Name:LYNNE
Last Name:MANN
Suffix:
Gender:F
Credentials:ARNP
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 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-4915
Mailing Address - Fax:515-643-8804
Practice Address - Street 1:411 LAUREL ST
Practice Address - Street 2:SUITE 2380
Practice Address - City:DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50314-3017
Practice Address - Country:US
Practice Address - Phone:515-643-4915
Practice Address - Fax:515-643-8804
Is Sole Proprietor?:No
Enumeration Date:2012-10-15
Last Update Date:2017-05-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAL-099124363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA440670134Medicare PIN