Provider Demographics
NPI:1912167263
Name:OLIVER, ROBIN A (CNM, MSN, FNP-C)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:A
Last Name:OLIVER
Suffix:
Gender:F
Credentials:CNM, MSN, FNP-C
Other - Prefix:
Other - First Name:ROBIN
Other - Middle Name:A
Other - Last Name:KANASKIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:55554 WHITNEY CT
Mailing Address - Street 2:
Mailing Address - City:SHELBY TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48315-6668
Mailing Address - Country:US
Mailing Address - Phone:586-504-0113
Mailing Address - Fax:
Practice Address - Street 1:1 CVS DR
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-6146
Practice Address - Country:US
Practice Address - Phone:866-389-2727
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-06-11
Last Update Date:2024-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704201458363LF0000X, 176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes176B00000XOther Service ProvidersMidwife
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI0P32150021Medicare PIN
MIP34780094Medicare PIN