Provider Demographics
NPI:1922298009
Name:O HERN, ROBIN (APRN,BC)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:O HERN
Suffix:
Gender:F
Credentials:APRN,BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 15849
Mailing Address - Street 2:# 1
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31416-2549
Mailing Address - Country:US
Mailing Address - Phone:912-303-3560
Mailing Address - Fax:912-303-3506
Practice Address - Street 1:1326 EISENHOWER DR
Practice Address - Street 2:BLDG 1
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3928
Practice Address - Country:US
Practice Address - Phone:912-691-4100
Practice Address - Fax:912-691-4289
Is Sole Proprietor?:No
Enumeration Date:2007-07-26
Last Update Date:2016-11-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GARN47440NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA202I504567Medicare PIN