Provider Demographics
NPI:1619840139
Name:MISTOLER, ROBIN LEE
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:LEE
Last Name:MISTOLER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:631 W TREEHAVEN DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:NE
Mailing Address - Zip Code:68521-3180
Mailing Address - Country:US
Mailing Address - Phone:531-281-9111
Mailing Address - Fax:
Practice Address - Street 1:631 W TREEHAVEN DR
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:NE
Practice Address - Zip Code:68521-3180
Practice Address - Country:US
Practice Address - Phone:531-281-9111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-29
Last Update Date:2025-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant