Provider Demographics
NPI:1326169335
Name:ROBERTSON, RHEA
Entity Type:Individual
Prefix:MS
First Name:RHEA
Middle Name:
Last Name:ROBERTSON
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:RHEA
Other - Middle Name:
Other - Last Name:AKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6496 SNIDER RD
Mailing Address - Street 2:
Mailing Address - City:LOVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:45140-9585
Mailing Address - Country:US
Mailing Address - Phone:513-965-8182
Mailing Address - Fax:
Practice Address - Street 1:6496 SNIDER RD
Practice Address - Street 2:
Practice Address - City:LOVELAND
Practice Address - State:OH
Practice Address - Zip Code:45140-9585
Practice Address - Country:US
Practice Address - Phone:513-965-8182
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-03
Last Update Date:2008-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH13900013332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2197126Medicaid
OH1326169335Medicare NSC