Provider Demographics
NPI:1528212842
Name:MCCANN, ROBYN ELIZABETH (LPN)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ELIZABETH
Last Name:MCCANN
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 1:464 RED SCHOOL HOUSE RD
Mailing Address - Street 2:
Mailing Address - City:FULTON
Mailing Address - State:NY
Mailing Address - Zip Code:13069-4467
Mailing Address - Country:US
Mailing Address - Phone:315-559-3815
Mailing Address - Fax:
Practice Address - Street 1:464 RED SCHOOL HOUSE ROAD
Practice Address - Street 2:
Practice Address - City:FULTON
Practice Address - State:NY
Practice Address - Zip Code:13069
Practice Address - Country:US
Practice Address - Phone:315-559-3815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-11-13
Last Update Date:2015-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY269972-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse