Provider Demographics
NPI:1700904984
Name:WHITAKER, ROBIN LYNN (RN)
Entity Type:Individual
Prefix:MS
First Name:ROBIN
Middle Name:LYNN
Last Name:WHITAKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:LYNN
Other - Last Name:WHITAKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:PO BOX 595
Mailing Address - Street 2:
Mailing Address - City:HIXSON
Mailing Address - State:TN
Mailing Address - Zip Code:37343-0595
Mailing Address - Country:US
Mailing Address - Phone:423-842-3031
Mailing Address - Fax:
Practice Address - Street 1:9527 W RIDGE TRAIL RD
Practice Address - Street 2:
Practice Address - City:SODDY DAISY
Practice Address - State:TN
Practice Address - Zip Code:37379-4018
Practice Address - Country:US
Practice Address - Phone:423-842-3031
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNRN0000087097163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse