Provider Demographics
NPI:1063798221
Name:WERTZ, ROBIN ANNETTE (CPRSS)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:ANNETTE
Last Name:WERTZ
Suffix:
Gender:F
Credentials:CPRSS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:433 NW 25TH ST
Mailing Address - Street 2:APT # 1
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73103-1530
Mailing Address - Country:US
Mailing Address - Phone:405-525-2300
Mailing Address - Fax:405-525-2422
Practice Address - Street 1:433 NW 25TH ST
Practice Address - Street 2:APT # 1
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73103-1530
Practice Address - Country:US
Practice Address - Phone:405-525-2300
Practice Address - Fax:405-525-2422
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-01
Last Update Date:2011-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator