Provider Demographics
NPI:1639484959
Name:ROBINSON, BETH LOUISE (LPN)
Entity Type:Individual
Prefix:MRS
First Name:BETH
Middle Name:LOUISE
Last Name:ROBINSON
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 1:3050 COUNTY ROAD 4
Mailing Address - Street 2:
Mailing Address - City:SWANTON
Mailing Address - State:OH
Mailing Address - Zip Code:43558-9734
Mailing Address - Country:US
Mailing Address - Phone:419-822-1815
Mailing Address - Fax:
Practice Address - Street 1:3050 COUNTY ROAD 4
Practice Address - Street 2:
Practice Address - City:SWANTON
Practice Address - State:OH
Practice Address - Zip Code:43558-9734
Practice Address - Country:US
Practice Address - Phone:419-822-1815
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN-126211-M-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse