Provider Demographics
NPI:1467690107
Name:MERTEN, ROBIN LYNNE (LPN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:LYNNE
Last Name:MERTEN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:LYNNE
Other - Last Name:MERTEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:N11131 COUNTY RD W
Mailing Address - Street 2:
Mailing Address - City:COLFAX
Mailing Address - State:WI
Mailing Address - Zip Code:54730-4832
Mailing Address - Country:US
Mailing Address - Phone:715-658-1619
Mailing Address - Fax:
Practice Address - Street 1:N11131 COUNTY RD W
Practice Address - Street 2:
Practice Address - City:COLFAX
Practice Address - State:WI
Practice Address - Zip Code:54730-4832
Practice Address - Country:US
Practice Address - Phone:715-658-1619
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-03
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI304861-031164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse