Provider Demographics
NPI:1952607087
Name:ROBIDOUX, ERIN KATHLEEN (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:KATHLEEN
Last Name:ROBIDOUX
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ERIN
Other - Middle Name:KATHLEEN
Other - Last Name:SPERL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:601 S US HIGHWAY 169
Mailing Address - Street 2:
Mailing Address - City:SMITHVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:64089-9317
Mailing Address - Country:US
Mailing Address - Phone:816-532-3999
Mailing Address - Fax:816-532-4465
Practice Address - Street 1:601 S US HIGHWAY 169
Practice Address - Street 2:
Practice Address - City:SMITHVILLE
Practice Address - State:MO
Practice Address - Zip Code:64089-9317
Practice Address - Country:US
Practice Address - Phone:816-532-3999
Practice Address - Fax:816-532-4465
Is Sole Proprietor?:No
Enumeration Date:2011-02-08
Last Update Date:2019-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011003375363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO2011003375OtherMISSOURI STATE BOARD OF NURSING FAMILY NURSE PRACTITIONER LICENSE NUMBER