Healthcare Provider Details

I. General information

NPI: 1326953829
Provider Name (Legal Business Name): ROBIN DAWN HENRY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/18/2026
Last Update Date: 08/18/2026
Certification Date: 08/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3525 N UNIVERSITY ST
PEORIA IL
61604-1324
US

IV. Provider business mailing address

3525 N UNIVERSITY ST
PEORIA IL
61604-1324
US

V. Phone/Fax

Practice location:
  • Phone: 309-886-9172
  • Fax: 309-509-4045
Mailing address:
  • Phone: 309-886-9172
  • Fax: 309-509-4045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041.346364
License Number StateIL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: