Provider Demographics
NPI:1629827563
Name:PAGE, ROBIN LYNN
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:LYNN
Last Name:PAGE
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:ROBIN
Other - Middle Name:LYNN
Other - Last Name:VASQUEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:21 DUNBILT CT
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-1203
Mailing Address - Country:US
Mailing Address - Phone:419-610-6423
Mailing Address - Fax:
Practice Address - Street 1:21 DUNBILT CT
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44907-1203
Practice Address - Country:US
Practice Address - Phone:419-610-6423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-05-14
Last Update Date:2024-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH343900000X
347C00000X, 376J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes376J00000XNursing Service Related ProvidersHomemakerGroup - Multi-Specialty
No343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No347C00000XTransportation ServicesPrivate Vehicle