Provider Demographics
NPI:1316340813
Name:ROBINSON, MARY ANNE (RN)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:ANNE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18002 W DESERT LN
Mailing Address - Street 2:
Mailing Address - City:SURPRISE
Mailing Address - State:AZ
Mailing Address - Zip Code:85388-1660
Mailing Address - Country:US
Mailing Address - Phone:623-876-7604
Mailing Address - Fax:623-876-7605
Practice Address - Street 1:15150 W MONDELL RD
Practice Address - Street 2:
Practice Address - City:SURPRISE
Practice Address - State:AZ
Practice Address - Zip Code:85374-3434
Practice Address - Country:US
Practice Address - Phone:623-876-7604
Practice Address - Fax:623-876-7605
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-29
Last Update Date:2014-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX257300163WS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WS0200XNursing Service ProvidersRegistered NurseSchool