Provider Demographics
NPI:1952388167
Name:ROBINSON, JANE S (RN, CNS)
Entity Type:Individual
Prefix:
First Name:JANE
Middle Name:S
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RN, CNS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:645 S ROGERS ST
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47403-2353
Mailing Address - Country:US
Mailing Address - Phone:812-339-1691
Mailing Address - Fax:812-339-8109
Practice Address - Street 1:1175 SOUTHVIEW DR
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:IN
Practice Address - Zip Code:46151-7062
Practice Address - Country:US
Practice Address - Phone:765-342-6616
Practice Address - Fax:765-342-2169
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2009-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN28079675163W00000X
IN70000120364S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364S00000XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse Specialist
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200311910AMedicaid
000000357972OtherANTHEM
000000357972OtherANTHEM
IN601530DMedicare ID - Type Unspecified