Provider Demographics
NPI:1710077169
Name:ROBY, KAREN LYNN (RPH)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:LYNN
Last Name:ROBY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3662 ICE AGE DR
Mailing Address - Street 2:
Mailing Address - City:MADISON
Mailing Address - State:WI
Mailing Address - Zip Code:53719-4000
Mailing Address - Country:US
Mailing Address - Phone:608-437-3001
Mailing Address - Fax:608-437-6480
Practice Address - Street 1:203 W MAIN ST
Practice Address - Street 2:
Practice Address - City:MOUNT HOREB
Practice Address - State:WI
Practice Address - Zip Code:53572-1914
Practice Address - Country:US
Practice Address - Phone:608-437-3001
Practice Address - Fax:608-437-6480
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI11358-040183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist