Provider Demographics
NPI:1760613731
Name:ELLIOTT, ROBYN ANNE (RN)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ANNE
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:ELLIOTT
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ROBYN ELLIOTT
Mailing Address - Street 1:6909 REDONDO PEAK RD NE
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87144-6759
Mailing Address - Country:US
Mailing Address - Phone:505-771-0040
Mailing Address - Fax:
Practice Address - Street 1:6909 REDONDO PEAK RD NE
Practice Address - Street 2:
Practice Address - City:RIO RANCHO
Practice Address - State:NM
Practice Address - Zip Code:87144-6759
Practice Address - Country:US
Practice Address - Phone:505-771-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-07
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMR18235163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care