Healthcare Provider Details

I. General information

NPI: 1144137241
Provider Name (Legal Business Name): ROBIN GAYLE ECKERT RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1708 N MAIN ST
OPP AL
36467-1401
US

IV. Provider business mailing address

19890 BEAVER DAM RD
ANDALUSIA AL
36420-6558
US

V. Phone/Fax

Practice location:
  • Phone: 334-493-5321
  • Fax:
Mailing address:
  • Phone: 334-493-5321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number1-060326
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: