Provider Demographics
NPI:1588916613
Name:LENN, ROBERT MICHAEL (RN)
Entity type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:MICHAEL
Last Name:LENN
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 MEMORIAL DR
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28546-6333
Mailing Address - Country:US
Mailing Address - Phone:910-353-5118
Mailing Address - Fax:910-577-1338
Practice Address - Street 1:215 MEMORIAL DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28546-6333
Practice Address - Country:US
Practice Address - Phone:910-353-5118
Practice Address - Fax:910-577-1338
Is Sole Proprietor?:No
Enumeration Date:2012-10-13
Last Update Date:2012-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC094349163WP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0808XNursing Service ProvidersRegistered NursePsychiatric/Mental Health