Provider Demographics
NPI:1356624118
Name:MARR, ROBIN (ANP-BC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MARR
Suffix:
Gender:F
Credentials:ANP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2790 SILVER FOX DR. SW
Mailing Address - Street 2:
Mailing Address - City:WARREN
Mailing Address - State:OH
Mailing Address - Zip Code:44481-9236
Mailing Address - Country:US
Mailing Address - Phone:330-824-3296
Mailing Address - Fax:
Practice Address - Street 1:6847 N. CHESTNUT STREET
Practice Address - Street 2:SUITE 310
Practice Address - City:RAVENNA
Practice Address - State:OH
Practice Address - Zip Code:44266
Practice Address - Country:US
Practice Address - Phone:330-296-2819
Practice Address - Fax:330-296-9503
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHCOA 12302-NP363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OHRN-193331OtherRN LICENSE
OHCOA-12302-NPOtherCOA NP