Provider Demographics
NPI:1841730678
Name:STOUT, ROBIN (RN, CDE)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:STOUT
Suffix:
Gender:F
Credentials:RN, CDE
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2225 E EVESHAM RD
Mailing Address - Street 2:SUITE 103
Mailing Address - City:VOORHEES
Mailing Address - State:NJ
Mailing Address - Zip Code:08043-1557
Mailing Address - Country:US
Mailing Address - Phone:856-325-4276
Mailing Address - Fax:856-325-4271
Practice Address - Street 1:2225 E EVESHAM RD
Practice Address - Street 2:SUITE 103
Practice Address - City:VOORHEES
Practice Address - State:NJ
Practice Address - Zip Code:08043-1557
Practice Address - Country:US
Practice Address - Phone:856-325-4276
Practice Address - Fax:856-325-4271
Is Sole Proprietor?:No
Enumeration Date:2017-02-27
Last Update Date:2017-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNR05329500163WD0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WD0400XNursing Service ProvidersRegistered NurseDiabetes Educator