Provider Demographics
NPI:1578934667
Name:GUENTHER, ROBYN (PA)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:GUENTHER
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:BUSHA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:3235 E MICHIGAN AVE STE 100
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:MI
Mailing Address - Zip Code:49202-3971
Mailing Address - Country:US
Mailing Address - Phone:517-787-3280
Mailing Address - Fax:517-787-9680
Practice Address - Street 1:1201 E MICHIGAN AVE
Practice Address - Street 2:
Practice Address - City:JACKSON
Practice Address - State:MI
Practice Address - Zip Code:49201-1852
Practice Address - Country:US
Practice Address - Phone:517-205-1431
Practice Address - Fax:517-205-1432
Is Sole Proprietor?:No
Enumeration Date:2015-10-14
Last Update Date:2021-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5601007576363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant