Provider Demographics
NPI:1992350565
Name:MASSEY, ROBYN (CPNP)
Entity type:Individual
Prefix:
First Name:ROBYN
Middle Name:
Last Name:MASSEY
Suffix:
Gender:F
Credentials:CPNP
Other - Prefix:
Other - First Name:ROBYN
Other - Middle Name:
Other - Last Name:GERBER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:139 WINDJAMMER LN
Mailing Address - Street 2:
Mailing Address - City:WILDWOOD
Mailing Address - State:MO
Mailing Address - Zip Code:63040-1628
Mailing Address - Country:US
Mailing Address - Phone:314-562-1557
Mailing Address - Fax:
Practice Address - Street 1:4100 FOREST PARK AVE
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63108-2806
Practice Address - Country:US
Practice Address - Phone:314-932-7333
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-09
Last Update Date:2019-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2014040553363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics