Healthcare Provider Details

I. General information

NPI: 1114991825
Provider Name (Legal Business Name): ROBYN MICHELLE AGNEW CNM, NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 12/30/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

290 N WAYTE LN
FRESNO CA
93701-2124
US

IV. Provider business mailing address

4910 E CLINTON WAY SUITE 101
FRESNO CA
93727-1560
US

V. Phone/Fax

Practice location:
  • Phone: 559-459-5755
  • Fax: 559-459-4454
Mailing address:
  • Phone: 559-443-2682
  • Fax: 559-443-2681

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN365884
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP9944
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code363LX0001X
TaxonomyObstetrics & Gynecology Nurse Practitioner
License NumberNP9944
License Number StateCA
# 4
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License NumberNMW1431
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: