Provider Demographics
NPI:1942638820
Name:LUTES, ROBIN R (CRNP)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:R
Last Name:LUTES
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:R
Other - Last Name:LUTES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:519 GREENSBURG PIKE
Mailing Address - Street 2:
Mailing Address - City:WEST NEWTON
Mailing Address - State:PA
Mailing Address - Zip Code:15089-2007
Mailing Address - Country:US
Mailing Address - Phone:724-350-5311
Mailing Address - Fax:724-649-0025
Practice Address - Street 1:860 ROSTRAVER RD
Practice Address - Street 2:
Practice Address - City:ROSTRAVER TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:15012-1945
Practice Address - Country:US
Practice Address - Phone:724-929-3278
Practice Address - Fax:724-929-3110
Is Sole Proprietor?:No
Enumeration Date:2013-10-31
Last Update Date:2019-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV82821163W00000X
PARN593018163W00000X
PAF0813366363LF0000X
PASP013321363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
330490FAEOtherMEDICARE