Provider Demographics
NPI:1740430735
Name:LAVIS, ROBIN LYNN (DEM)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNN
Last Name:LAVIS
Suffix:
Gender:F
Credentials:DEM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12473 BUSSA RD
Mailing Address - Street 2:
Mailing Address - City:RAPID CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49676-9620
Mailing Address - Country:US
Mailing Address - Phone:231-264-9144
Mailing Address - Fax:231-264-9144
Practice Address - Street 1:12473 BUSSA RD
Practice Address - Street 2:
Practice Address - City:RAPID CITY
Practice Address - State:MI
Practice Address - Zip Code:49676-9620
Practice Address - Country:US
Practice Address - Phone:231-264-9144
Practice Address - Fax:231-264-9144
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-25
Last Update Date:2008-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife