Healthcare Provider Details

I. General information

NPI: 1164624136
Provider Name (Legal Business Name): ROBIN ELIZABETH PROCTOR CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 UPPER RAGSDALE DR
MONTEREY CA
93940-5736
US

IV. Provider business mailing address

2 UPPER RAGSDALE DR STE 200
MONTEREY CA
93940-5736
US

V. Phone/Fax

Practice location:
  • Phone: 831-649-7220
  • Fax: 831-649-7221
Mailing address:
  • Phone: 215-829-3445
  • Fax: 831-649-7221

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number95022155
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: