Provider Demographics
NPI:1760865273
Name:MCKENRICK, ROBIN JEAN (RN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:JEAN
Last Name:MCKENRICK
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:JEAN
Other - Last Name:BARBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 203
Mailing Address - Street 2:80 T
Mailing Address - City:GRAMPIAN
Mailing Address - State:PA
Mailing Address - Zip Code:16838
Mailing Address - Country:US
Mailing Address - Phone:814-236-2106
Mailing Address - Fax:
Practice Address - Street 1:80 TURNER RD
Practice Address - Street 2:
Practice Address - City:GRAMPIAN
Practice Address - State:PA
Practice Address - Zip Code:16838
Practice Address - Country:US
Practice Address - Phone:814-236-2106
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-07-01
Last Update Date:2015-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN 265803L163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse