Provider Demographics
NPI:1932444874
Name:ROBINSON, AUDREA YVONNE (LPN)
Entity Type:Individual
Prefix:MS
First Name:AUDREA
Middle Name:YVONNE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 WALBRIDGE AVE
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43609-2250
Mailing Address - Country:US
Mailing Address - Phone:319-243-4208
Mailing Address - Fax:
Practice Address - Street 1:1158 WALBRIDGE AVE
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43609-2250
Practice Address - Country:US
Practice Address - Phone:319-243-4208
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-04
Last Update Date:2012-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHPN 148903164X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164X00000XNursing Service ProvidersLicensed Vocational Nurse