Provider Demographics
NPI:1013287903
Name:ROBINSON, DENA JOANN (LPN)
Entity Type:Individual
Prefix:MS
First Name:DENA
Middle Name:JOANN
Last Name:ROBINSON
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 1:11331 PARKSIDE AVE NE
Mailing Address - Street 2:
Mailing Address - City:ALLIANCE
Mailing Address - State:OH
Mailing Address - Zip Code:44601-1248
Mailing Address - Country:US
Mailing Address - Phone:330-821-2045
Mailing Address - Fax:
Practice Address - Street 1:11331 PARKSIDE AVE NE
Practice Address - Street 2:
Practice Address - City:ALLIANCE
Practice Address - State:OH
Practice Address - Zip Code:44601-1248
Practice Address - Country:US
Practice Address - Phone:330-821-2045
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-01-09
Last Update Date:2012-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN.124688164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse