Provider Demographics
NPI:1720274285
Name:ROBARDS, DONITA ANN (RN)
Entity Type:Individual
Prefix:MS
First Name:DONITA
Middle Name:ANN
Last Name:ROBARDS
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:1256 WALKER AVE NW
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49504-4067
Mailing Address - Country:US
Mailing Address - Phone:616-235-2910
Mailing Address - Fax:616-235-1436
Practice Address - Street 1:717 N CENTER DR NW
Practice Address - Street 2:
Practice Address - City:WALKER
Practice Address - State:MI
Practice Address - Zip Code:49544-8215
Practice Address - Country:US
Practice Address - Phone:616-647-2599
Practice Address - Fax:616-647-2596
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-19
Last Update Date:2007-09-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704192524163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult