Provider Demographics
NPI:1013146760
Name:KERRIGAN, ROBYN LYNN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:ROBYN
Middle Name:LYNN
Last Name:KERRIGAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 PRIVATE ROAD 19
Mailing Address - Street 2:
Mailing Address - City:OLIVE BRIDGE
Mailing Address - State:NY
Mailing Address - Zip Code:12461
Mailing Address - Country:US
Mailing Address - Phone:845-657-4270
Mailing Address - Fax:845-657-4270
Practice Address - Street 1:10 PRIVATE ROAD 19
Practice Address - Street 2:
Practice Address - City:OLIVE BRIDGE
Practice Address - State:NY
Practice Address - Zip Code:12461
Practice Address - Country:US
Practice Address - Phone:845-657-4270
Practice Address - Fax:845-657-4270
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-02
Last Update Date:2009-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY253720164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse