Healthcare Provider Details

I. General information

NPI: 1952388167
Provider Name (Legal Business Name): JANE S ROBINSON RN, CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/29/2005
Last Update Date: 05/03/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 SOUTHVIEW DR
MARTINSVILLE IN
46151-7062
US

IV. Provider business mailing address

645 S ROGERS ST
BLOOMINGTON IN
47403-2353
US

V. Phone/Fax

Practice location:
  • Phone: 765-342-6616
  • Fax: 765-342-2169
Mailing address:
  • Phone: 812-339-1691
  • Fax: 812-339-8109

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License Number70000120
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number28079675
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: