Provider Demographics
NPI:1952699019
Name:ROBINETT, STACI RENEA (ARNP-C)
Entity Type:Individual
Prefix:
First Name:STACI
Middle Name:RENEA
Last Name:ROBINETT
Suffix:
Gender:F
Credentials:ARNP-C
Other - Prefix:
Other - First Name:STACI
Other - Middle Name:RENEA
Other - Last Name:BREEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1105 SUNSET AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-3739
Mailing Address - Country:US
Mailing Address - Phone:785-532-6544
Mailing Address - Fax:
Practice Address - Street 1:1105 SUNSET AVE
Practice Address - Street 2:
Practice Address - City:MANHATTAN
Practice Address - State:KS
Practice Address - Zip Code:66502
Practice Address - Country:US
Practice Address - Phone:785-532-6544
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-07-11
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS53-75385-061363LX0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology