Provider Demographics
NPI:1407650468
Name:ROBINSON, DEATYANA (LPN)
Entity type:Individual
Prefix:
First Name:DEATYANA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:
Credentials:LPN
Other - Prefix:
Other - First Name:DEATYANA
Other - Middle Name:
Other - Last Name:WALTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LPN
Mailing Address - Street 1:7732 N 87TH ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68122-5267
Mailing Address - Country:US
Mailing Address - Phone:402-312-4456
Mailing Address - Fax:
Practice Address - Street 1:16005 AUDREY ST
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68136-3014
Practice Address - Country:US
Practice Address - Phone:402-312-4456
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-01
Last Update Date:2025-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE27324164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse