Provider Demographics
NPI:1679748768
Name:TROUT, ROBIN KAYE (RN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:KAYE
Last Name:TROUT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:KAYE
Other - Last Name:ELLIS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:515 HOLLY STREET
Mailing Address - Street 2:
Mailing Address - City:MCGEHEE
Mailing Address - State:AR
Mailing Address - Zip Code:71654
Mailing Address - Country:US
Mailing Address - Phone:870-222-4500
Mailing Address - Fax:870-222-4505
Practice Address - Street 1:515 HOLLY STREET
Practice Address - Street 2:
Practice Address - City:MCGEHEE
Practice Address - State:AR
Practice Address - Zip Code:71654
Practice Address - Country:US
Practice Address - Phone:870-222-4500
Practice Address - Fax:870-222-4505
Is Sole Proprietor?:No
Enumeration Date:2008-04-29
Last Update Date:2008-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR65229163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse