Provider Demographics
NPI:1194027565
Name:PERON, ROBERT M (ACNP-BC, CNP)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:M
Last Name:PERON
Suffix:
Gender:M
Credentials:ACNP-BC, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7700 UNIVERSITY DR
Mailing Address - Street 2:WEST CHESTER HOSPITAL
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-2505
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7700 UNIVERSITY DR
Practice Address - Street 2:WEST CHESTER HOSPITAL
Practice Address - City:WEST CHESTER
Practice Address - State:OH
Practice Address - Zip Code:45069-2505
Practice Address - Country:US
Practice Address - Phone:513-298-8271
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-17
Last Update Date:2015-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 11591 - NP363LA2100X
NY430152 F363LA2100X
OHCOA.11591-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0099881Medicaid
OHH322721Medicare PIN