Provider Demographics
NPI:1689724791
Name:TRIMBLE, ROBYN LYNN
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:LYNN
Last Name:TRIMBLE
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 1:2361 LORIS DR
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45449-3219
Mailing Address - Country:US
Mailing Address - Phone:937-433-6475
Mailing Address - Fax:
Practice Address - Street 1:2361 LORIS DR
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45449-3219
Practice Address - Country:US
Practice Address - Phone:937-433-6475
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2623987Medicaid