Provider Demographics
NPI:1669663324
Name:STINNETT, ROBYN SUE
Entity Type:Individual
Prefix:DR
First Name:ROBYN
Middle Name:SUE
Last Name:STINNETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 LYNDON LN
Mailing Address - Street 2:SUITE 106
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-5550
Mailing Address - Country:US
Mailing Address - Phone:502-327-7701
Mailing Address - Fax:502-327-7705
Practice Address - Street 1:105 LYNDON LN
Practice Address - Street 2:SUITE 106
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-5550
Practice Address - Country:US
Practice Address - Phone:502-327-7701
Practice Address - Fax:502-327-7705
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-07
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY288432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
KYG12728Medicare UPIN