Provider Demographics
NPI:1356886618
Name:ROBUCK, HALEY (CNP)
Entity type:Individual
Prefix:MRS
First Name:HALEY
Middle Name:
Last Name:ROBUCK
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 BENEDICT AVE
Mailing Address - Street 2:
Mailing Address - City:NORWALK
Mailing Address - State:OH
Mailing Address - Zip Code:44857-2374
Mailing Address - Country:US
Mailing Address - Phone:419-668-8101
Mailing Address - Fax:
Practice Address - Street 1:224 W LORAIN ST STE 100
Practice Address - Street 2:
Practice Address - City:OBERLIN
Practice Address - State:OH
Practice Address - Zip Code:44074-1087
Practice Address - Country:US
Practice Address - Phone:440-775-1881
Practice Address - Fax:440-744-5707
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-22
Last Update Date:2024-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.18803363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily