Provider Demographics
NPI:1790906790
Name:ROBATOR, NANCY ILLINGWORTH (PT)
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:ILLINGWORTH
Last Name:ROBATOR
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 NEWBURY LN
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:NH
Mailing Address - Zip Code:03110-4653
Mailing Address - Country:US
Mailing Address - Phone:603-472-2773
Mailing Address - Fax:
Practice Address - Street 1:40 S RIVER RD
Practice Address - Street 2:UNIT 58
Practice Address - City:BEDFORD
Practice Address - State:NH
Practice Address - Zip Code:03110-6719
Practice Address - Country:US
Practice Address - Phone:603-626-4205
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH241225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30392138Medicaid
NH30392138Medicaid