Provider Demographics
NPI:1790176469
Name:MENEGUZZO, ROBIN (FNP-C)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MENEGUZZO
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 3RD ST
Mailing Address - Street 2:
Mailing Address - City:LAURIUM
Mailing Address - State:MI
Mailing Address - Zip Code:49913-2161
Mailing Address - Country:US
Mailing Address - Phone:906-228-2088
Mailing Address - Fax:
Practice Address - Street 1:65 3RD ST
Practice Address - Street 2:
Practice Address - City:LAURIUM
Practice Address - State:MI
Practice Address - Zip Code:49913-2161
Practice Address - Country:US
Practice Address - Phone:906-228-2088
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-02-16
Last Update Date:2023-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704284791363LF0000X
MNCNP4608363LF0000X
WI23029630363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily