Provider Demographics
NPI:1992365001
Name:RAFTER, ROBYN ANNE (MSN, APRN, FPNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:ANNE
Last Name:RAFTER
Suffix:
Gender:F
Credentials:MSN, APRN, FPNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5160 N 175TH CIR
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68116-3196
Mailing Address - Country:US
Mailing Address - Phone:402-517-7996
Mailing Address - Fax:
Practice Address - Street 1:5160 N 175TH CIR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68116-3196
Practice Address - Country:US
Practice Address - Phone:402-517-7996
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2019-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE112688363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NE112688OtherNA