Provider Demographics
NPI:1922862655
Name:WINGROVE, ROBIN L
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:L
Last Name:WINGROVE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:733 ASH ST
Mailing Address - Street 2:
Mailing Address - City:WILLARD
Mailing Address - State:OH
Mailing Address - Zip Code:44890-1604
Mailing Address - Country:US
Mailing Address - Phone:419-577-3195
Mailing Address - Fax:
Practice Address - Street 1:733 ASH ST
Practice Address - Street 2:
Practice Address - City:WILLARD
Practice Address - State:OH
Practice Address - Zip Code:44890-1604
Practice Address - Country:US
Practice Address - Phone:419-577-3195
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-02-13
Last Update Date:2024-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes347C00000XTransportation ServicesPrivate Vehicle
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No376J00000XNursing Service Related ProvidersHomemaker