Provider Demographics
NPI:1700081114
Name:HERZOG, ROBIN AIMEE (MSN, CRNP)
Entity Type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:AIMEE
Last Name:HERZOG
Suffix:
Gender:F
Credentials:MSN, CRNP
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Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:3400 CIVIC CENTER BLVD
Mailing Address - Street 2:3 PERELMAN WEST
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19104-4306
Mailing Address - Country:US
Mailing Address - Phone:215-615-3360
Mailing Address - Fax:215-615-3347
Practice Address - Street 1:3400 CIVIC CENTER BLVD
Practice Address - Street 2:3 PERELMAN WEST
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4306
Practice Address - Country:US
Practice Address - Phone:215-615-3360
Practice Address - Fax:215-615-3349
Is Sole Proprietor?:No
Enumeration Date:2007-06-15
Last Update Date:2009-02-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PARN529574L163WX0200X
PASP009749363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health