Provider Demographics
NPI:1225443443
Name:ROBINSON, MARY F (LPN)
Entity Type:Individual
Prefix:
First Name:MARY
Middle Name:F
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 SENECA DR
Mailing Address - Street 2:
Mailing Address - City:PENDLETON
Mailing Address - State:IN
Mailing Address - Zip Code:46064-9703
Mailing Address - Country:US
Mailing Address - Phone:317-590-4274
Mailing Address - Fax:
Practice Address - Street 1:805 SENECA DR
Practice Address - Street 2:
Practice Address - City:PENDLETON
Practice Address - State:IN
Practice Address - Zip Code:46064-9703
Practice Address - Country:US
Practice Address - Phone:317-590-4274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-26
Last Update Date:2016-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN27040459A164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse