Provider Demographics
NPI:1538684998
Name:FLETCHER DEPREE, ROBIN G (DNP, CNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:G
Last Name:FLETCHER DEPREE
Suffix:
Gender:F
Credentials:DNP, CNP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:G
Other - Last Name:FLETCHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:361 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAREHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02571-2153
Mailing Address - Country:US
Mailing Address - Phone:774-255-0097
Mailing Address - Fax:
Practice Address - Street 1:361 MAIN ST
Practice Address - Street 2:
Practice Address - City:WAREHAM
Practice Address - State:MA
Practice Address - Zip Code:02571-2153
Practice Address - Country:US
Practice Address - Phone:774-678-7319
Practice Address - Fax:508-291-9907
Is Sole Proprietor?:Yes
Enumeration Date:2017-08-07
Last Update Date:2019-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN251449363LA2200X, 363LG0600X, 363LP2300X
RIAPRN01673363LA2200X, 363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology