Provider Demographics
NPI:1891169256
Name:ROBINSON, STEPHANIE L (NP-C)
Entity Type:Individual
Prefix:
First Name:STEPHANIE
Middle Name:L
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 W WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:MO
Mailing Address - Zip Code:63548-9038
Mailing Address - Country:US
Mailing Address - Phone:660-457-3772
Mailing Address - Fax:
Practice Address - Street 1:1000 W WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:MO
Practice Address - Zip Code:63548-9038
Practice Address - Country:US
Practice Address - Phone:660-457-3772
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-11-23
Last Update Date:2018-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013029342363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO1871048967Medicaid