Provider Demographics
NPI:1952693517
Name:TRUPP, ROBIN J (PHD, ACNP)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:J
Last Name:TRUPP
Suffix:
Gender:F
Credentials:PHD, ACNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 WHITE DOGWOOD RD
Mailing Address - Street 2:
Mailing Address - City:APEX
Mailing Address - State:NC
Mailing Address - Zip Code:27502
Mailing Address - Country:US
Mailing Address - Phone:919-267-6029
Mailing Address - Fax:
Practice Address - Street 1:40 DUKE MEDICINE
Practice Address - Street 2:CLINIC 2K, ROOM 2203
Practice Address - City:DURHAM
Practice Address - State:NC
Practice Address - Zip Code:27710
Practice Address - Country:US
Practice Address - Phone:919-613-3261
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-13
Last Update Date:2013-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL9302082363LA2100X
OH21137548363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC1952693517Medicaid
NC1952693517Medicare UPIN
NC1952693517Medicaid