Provider Demographics
NPI:1982005948
Name:NEIDERER, ROBYN ELIZABETH (CRNP)
Entity Type:Individual
Prefix:
First Name:ROBYN
Middle Name:ELIZABETH
Last Name:NEIDERER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:838 KARLYN LN
Mailing Address - Street 2:
Mailing Address - City:COLLEGEVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:19426-4142
Mailing Address - Country:US
Mailing Address - Phone:610-489-4757
Mailing Address - Fax:
Practice Address - Street 1:838 KARLYN LN
Practice Address - Street 2:
Practice Address - City:COLLEGEVILLE
Practice Address - State:PA
Practice Address - Zip Code:19426-4142
Practice Address - Country:US
Practice Address - Phone:610-489-4757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-09
Last Update Date:2014-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN357468L163W00000X
PASP009604363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No163W00000XNursing Service ProvidersRegistered Nurse