Provider Demographics
NPI:1285709485
Name:ROSS, ROBIN BROWDY (APRN)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:BROWDY
Last Name:ROSS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:370 E SOUTH TEMPLE
Mailing Address - Street 2:SUITE 550
Mailing Address - City:SLC
Mailing Address - State:UT
Mailing Address - Zip Code:84111-1206
Mailing Address - Country:US
Mailing Address - Phone:801-582-8013
Mailing Address - Fax:801-355-9322
Practice Address - Street 1:370 E SOUTH TEMPLE
Practice Address - Street 2:SUITE 550
Practice Address - City:SLC
Practice Address - State:UT
Practice Address - Zip Code:84111-1206
Practice Address - Country:US
Practice Address - Phone:801-582-8013
Practice Address - Fax:801-355-9322
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-22
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT1979094405363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health