Provider Demographics
NPI:1700045796
Name:ROBBIANO, KATHLEEN ANN (RN, CNM)
Entity Type:Individual
Prefix:
First Name:KATHLEEN
Middle Name:ANN
Last Name:ROBBIANO
Suffix:
Gender:F
Credentials:RN, CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:583 SUMMERFIELD RD
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-5239
Mailing Address - Country:US
Mailing Address - Phone:707-539-1544
Mailing Address - Fax:707-539-0686
Practice Address - Street 1:583 SUMMERFIELD RD
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-5239
Practice Address - Country:US
Practice Address - Phone:707-539-1544
Practice Address - Fax:707-539-0686
Is Sole Proprietor?:No
Enumeration Date:2008-06-04
Last Update Date:2011-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA341367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife