Provider Demographics
NPI:1578839882
Name:MEHRTENS, ROBYN R (RPH)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:R
Last Name:MEHRTENS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14010 W 71ST TER
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:KS
Mailing Address - Zip Code:66216-5503
Mailing Address - Country:US
Mailing Address - Phone:913-962-9778
Mailing Address - Fax:
Practice Address - Street 1:9350 MARSHALL DR
Practice Address - Street 2:
Practice Address - City:LENEXA
Practice Address - State:KS
Practice Address - Zip Code:66215-3845
Practice Address - Country:US
Practice Address - Phone:913-227-3702
Practice Address - Fax:913-227-3722
Is Sole Proprietor?:Yes
Enumeration Date:2012-03-30
Last Update Date:2012-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1-134171835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist