Provider Demographics
NPI:1164776928
Name:ASHLEY, ROBIN (RN)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:
Last Name:ASHLEY
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:SPEAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:15 KLODA RD
Mailing Address - Street 2:
Mailing Address - City:LISLE
Mailing Address - State:NY
Mailing Address - Zip Code:13797-1531
Mailing Address - Country:US
Mailing Address - Phone:607-760-5265
Mailing Address - Fax:
Practice Address - Street 1:435 GLENWOOD RD
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13905-1606
Practice Address - Country:US
Practice Address - Phone:607-763-3684
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-01
Last Update Date:2012-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY467454163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY467454OtherR.N. LICENSE