Provider Demographics
NPI:1639863301
Name:MAYLE, ROBIN (LPN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MAYLE
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 1:3801 WHIPPLE AVE NW STE 1
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:OH
Mailing Address - Zip Code:44718-4802
Mailing Address - Country:US
Mailing Address - Phone:330-413-3681
Mailing Address - Fax:
Practice Address - Street 1:3801 WHIPPLE AVE NW STE 1
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44718-4802
Practice Address - Country:US
Practice Address - Phone:330-413-3681
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-06
Last Update Date:2023-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHLPN.183943.MEDS-IV164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse