Provider Demographics
NPI:1750456224
Name:CAVERO, ROBIN L (FNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:CAVERO
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:L
Other - Last Name:MORRIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP
Mailing Address - Street 1:1246 W STONE MEADOW WAY
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:MO
Mailing Address - Zip Code:65810-1609
Mailing Address - Country:US
Mailing Address - Phone:417-631-2303
Mailing Address - Fax:417-890-4677
Practice Address - Street 1:1514 W LARK ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MO
Practice Address - Zip Code:65810-2262
Practice Address - Country:US
Practice Address - Phone:417-631-2303
Practice Address - Fax:417-890-4677
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2009-04-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO151552363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOOTH000Medicare UPIN