Provider Demographics
NPI:1245289602
Name:WHEELER, ROBYN LEE (ARNP-FNP-BC)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:LEE
Last Name:WHEELER
Suffix:
Gender:F
Credentials:ARNP-FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 PLEASANT ST APT 353
Mailing Address - Street 2:
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50266-5483
Mailing Address - Country:US
Mailing Address - Phone:515-327-7426
Mailing Address - Fax:
Practice Address - Street 1:4601 PLEASANT ST APT 353
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-5483
Practice Address - Country:US
Practice Address - Phone:515-327-7426
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-10
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA098375363LA2200X, 363LF0000X
IAA-098375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0484600Medicaid
IA1245289602Medicaid
IA0484600Medicaid
Q67778Medicare UPIN
IAI17378Medicare PIN