Provider Demographics
NPI:1982098018
Name:HISER, ROBIN S (APRN)
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:S
Last Name:HISER
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:
Other - Last Name:MADISON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:3430 NEWBURG RD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40218-2458
Mailing Address - Country:US
Mailing Address - Phone:502-893-3963
Mailing Address - Fax:502-897-1792
Practice Address - Street 1:3430 NEWBURG RD
Practice Address - Street 2:SUITE 250
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40218-2458
Practice Address - Country:US
Practice Address - Phone:502-893-3963
Practice Address - Fax:502-897-1792
Is Sole Proprietor?:No
Enumeration Date:2015-03-26
Last Update Date:2015-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN19607363LF0000X
KY3009764363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily