Provider Demographics
NPI:1295469989
Name:ROBBINS, JODI ANN (LPN)
Entity Type:Individual
Prefix:
First Name:JODI
Middle Name:ANN
Last Name:ROBBINS
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 1:217 HECTOR ST
Mailing Address - Street 2:
Mailing Address - City:ITHACA
Mailing Address - State:NY
Mailing Address - Zip Code:14850-3101
Mailing Address - Country:US
Mailing Address - Phone:607-297-8906
Mailing Address - Fax:
Practice Address - Street 1:217 HECTOR ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-3101
Practice Address - Country:US
Practice Address - Phone:607-297-8906
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-07-11
Last Update Date:2022-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338122164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse