Healthcare Provider Details

I. General information

NPI: 1568448652
Provider Name (Legal Business Name): EUGENE NOLAND ROBB APRN, CNS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

645 SOUTH ROGERS STREET
BLOOMINGTON IN
47403
US

IV. Provider business mailing address

645 SOUTH ROGERS STREET
BLOOMINGTON IN
47403
US

V. Phone/Fax

Practice location:
  • Phone: 812-339-1691
  • Fax: 812-339-8109
Mailing address:
  • Phone: 812-339-1691
  • Fax: 812-339-8109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28118429
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code364SP0809X
TaxonomyAdult Psychiatric/Mental Health Clinical Nurse Specialist
License Number70000141A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: