Provider Demographics
NPI:1477277762
Name:LANCASTER, ROBIN (MSN, RN, PMHN-BC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:LANCASTER
Suffix:
Gender:F
Credentials:MSN, RN, PMHN-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:70 SW CENTURY DR # 100-5019
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3557
Mailing Address - Country:US
Mailing Address - Phone:541-419-3785
Mailing Address - Fax:
Practice Address - Street 1:70 SW CENTURY DR # 100-5019
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3557
Practice Address - Country:US
Practice Address - Phone:541-419-3785
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-29
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN263930163W00000X, 163WC0400X
OR201701134163WM0705X, 163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health
Yes163W00000XNursing Service ProvidersRegistered Nurse
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
No163WM0705XNursing Service ProvidersRegistered NurseMedical-Surgical