Provider Demographics
NPI:1497281307
Name:MARGRAVES, ROBIN MARIE (LPN)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:MARIE
Last Name:MARGRAVES
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 1:407 RIVERVIEW AVE
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:MI
Mailing Address - Zip Code:48162-2666
Mailing Address - Country:US
Mailing Address - Phone:734-770-5402
Mailing Address - Fax:
Practice Address - Street 1:407 RIVERVIEW AVE
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:MI
Practice Address - Zip Code:48162-2666
Practice Address - Country:US
Practice Address - Phone:734-770-5402
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-05-11
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4703111467164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse