Provider Demographics
NPI:1477975290
Name:SMITH, ROBIN ELIZABETH (NP-C, RN, MSN)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:NP-C, RN, MSN
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:ELIZABETH
Other - Last Name:RADCLIFFE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:72 HAZELWOOD CT
Mailing Address - Street 2:
Mailing Address - City:TERRE HAUTE
Mailing Address - State:IN
Mailing Address - Zip Code:47802-4973
Mailing Address - Country:US
Mailing Address - Phone:567-277-0287
Mailing Address - Fax:
Practice Address - Street 1:4001 WABASH AVE
Practice Address - Street 2:
Practice Address - City:TERRE HAUTE
Practice Address - State:IN
Practice Address - Zip Code:47803
Practice Address - Country:US
Practice Address - Phone:812-238-7788
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-01-14
Last Update Date:2018-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC221666163W00000X
SC18575A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse