Provider Demographics
NPI:1811331614
Name:ANDERSON, ROBBI DORAN (RN BSN)
Entity type:Individual
Prefix:MRS
First Name:ROBBI
Middle Name:DORAN
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:RN BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:819 LINWOOD AVE SW
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-6849
Mailing Address - Country:US
Mailing Address - Phone:360-753-3382
Mailing Address - Fax:
Practice Address - Street 1:819 LINWOOD AVE SW
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-6849
Practice Address - Country:US
Practice Address - Phone:360-753-3382
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-04-23
Last Update Date:2013-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN00116111163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA163WH00000XOtherPRIVATE LICENSED NURSE TAXONOMY CODE STATE OF WA