Provider Demographics
NPI:1508101379
Name:ROBINETTE, JEFFREY A (LPN)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:A
Last Name:ROBINETTE
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8595 OLENCREST DR
Mailing Address - Street 2:
Mailing Address - City:LEWIS CENTER
Mailing Address - State:OH
Mailing Address - Zip Code:43035-8872
Mailing Address - Country:US
Mailing Address - Phone:614-893-7784
Mailing Address - Fax:
Practice Address - Street 1:8595 OLENCREST DR
Practice Address - Street 2:
Practice Address - City:LEWIS CENTER
Practice Address - State:OH
Practice Address - Zip Code:43035-8872
Practice Address - Country:US
Practice Address - Phone:614-893-7784
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-05
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN080999164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse