Provider Demographics
NPI:1235283706
Name:PETIT, ROBIN C (MSN, ARNP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:C
Last Name:PETIT
Suffix:
Gender:F
Credentials:MSN, ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1521 NE 16TH AVE
Mailing Address - Street 2:
Mailing Address - City:FORT LAUDERDALE
Mailing Address - State:FL
Mailing Address - Zip Code:33304-4850
Mailing Address - Country:US
Mailing Address - Phone:954-565-9002
Mailing Address - Fax:
Practice Address - Street 1:1521 NE 16TH AVE
Practice Address - Street 2:
Practice Address - City:FORT LAUDERDALE
Practice Address - State:FL
Practice Address - Zip Code:33304-4850
Practice Address - Country:US
Practice Address - Phone:954-565-9002
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1188592163WC1600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC1600XNursing Service ProvidersRegistered NurseContinuing Education/Staff Development