Provider Demographics
NPI:1699227405
Name:RODRIGUEZ, ROBIN (RN MSN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:RODRIGUEZ
Suffix:
Gender:F
Credentials:RN MSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2500 NORTHGATE DR
Mailing Address - Street 2:
Mailing Address - City:FEASTERVILLE TREVOSE
Mailing Address - State:PA
Mailing Address - Zip Code:19053-6950
Mailing Address - Country:US
Mailing Address - Phone:268-991-7601
Mailing Address - Fax:
Practice Address - Street 1:2500 NORTHGATE DR
Practice Address - Street 2:
Practice Address - City:FEASTERVILLE TREVOSE
Practice Address - State:PA
Practice Address - Zip Code:19053-6950
Practice Address - Country:US
Practice Address - Phone:268-991-7601
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-27
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN294537L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA251T00000XOtherTAX CODE