Provider Demographics
NPI:1811122203
Name:BEAGLE, ROBIN E (RN, MS, ACNP-BC)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:E
Last Name:BEAGLE
Suffix:
Gender:F
Credentials:RN, MS, ACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4261 HEATHERDALE CT
Mailing Address - Street 2:
Mailing Address - City:MOORPARK
Mailing Address - State:CA
Mailing Address - Zip Code:93021-3738
Mailing Address - Country:US
Mailing Address - Phone:805-523-1168
Mailing Address - Fax:
Practice Address - Street 1:4261 HEATHERDALE CT
Practice Address - Street 2:
Practice Address - City:MOORPARK
Practice Address - State:CA
Practice Address - Zip Code:93021-3738
Practice Address - Country:US
Practice Address - Phone:805-523-1168
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA530098363LA2100X, 363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health