Provider Demographics
NPI:1528483237
Name:MASSEY, ROBIN
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:
Other - Last Name:MASSEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DEM
Mailing Address - Street 1:603 HIGH ST
Mailing Address - Street 2:
Mailing Address - City:BOONVILLE
Mailing Address - State:MO
Mailing Address - Zip Code:65233-1212
Mailing Address - Country:US
Mailing Address - Phone:660-441-8818
Mailing Address - Fax:
Practice Address - Street 1:603 HIGH ST
Practice Address - Street 2:
Practice Address - City:BOONVILLE
Practice Address - State:MO
Practice Address - Zip Code:65233-1212
Practice Address - Country:US
Practice Address - Phone:660-441-8818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175M00000XOther Service ProvidersMidwife, Lay