Provider Demographics
NPI:1841611068
Name:WOOD, ROBIN (RN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 BRAGG ST
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:AR
Mailing Address - Zip Code:71671-2500
Mailing Address - Country:US
Mailing Address - Phone:870-226-7844
Mailing Address - Fax:
Practice Address - Street 1:206 BRAGG ST
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:AR
Practice Address - Zip Code:71671-2500
Practice Address - Country:US
Practice Address - Phone:870-226-7844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-12-16
Last Update Date:2013-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR084464163WP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0200XNursing Service ProvidersRegistered NursePediatrics