Provider Demographics
NPI:1508662347
Name:GRUNDEN, ROBYN
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:GRUNDEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:LUSBY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:428 N SANTA FE AVE
Mailing Address - Street 2:
Mailing Address - City:BARTLESVILLE
Mailing Address - State:OK
Mailing Address - Zip Code:74003-2025
Mailing Address - Country:US
Mailing Address - Phone:817-714-1529
Mailing Address - Fax:
Practice Address - Street 1:2325 S HARVARD AVE
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74114-3300
Practice Address - Country:US
Practice Address - Phone:918-712-4301
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-21
Last Update Date:2025-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist