MEDICARE: MRS. LYNN M ROBINSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	163W00000X	Registered Nurse	RN054772	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RN054772	OTHER	AZ	RN LICENCE

General Provider Information

NPI Number	:	1952555849
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. LYNN M ROBINSON

Provider Business Mailing Address
First Line	:	6602 N 75TH AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85303-3504
Country	:	US
Telephone Number	:	623-435-6100
Fax Number	:	623-435-6078

Provider Business Practice Location Address
First Line	:	6602 N 75TH AVE
Second Line	:
City	:	GLENDALE
State	:	AZ
Zip	:	85303-3504
Country	:	US
Telephone Number	:	623-435-6100
Fax Number	:	623-435-6078

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/05/2008
Last Update Date	:	11/05/2008

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