Provider Demographics
NPI:1639406762
Name:ROBINSON, AMBER MARIE (LPN)
Entity Type:Individual
Prefix:
First Name:AMBER
Middle Name:MARIE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:AMBER
Other - Middle Name:MARIE
Other - Last Name:BARTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:4132 COLONIAL BLVD
Mailing Address - Street 2:
Mailing Address - City:BATAVIA
Mailing Address - State:NY
Mailing Address - Zip Code:14020-1208
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4132 COLONIAL BLVD
Practice Address - Street 2:
Practice Address - City:BATAVIA
Practice Address - State:NY
Practice Address - Zip Code:14020-1208
Practice Address - Country:US
Practice Address - Phone:585-690-8223
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-10
Last Update Date:2009-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY10-263032164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse