Healthcare Provider Details

I. General information

NPI: 1770496358
Provider Name (Legal Business Name): ROBYN EDDY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5317 HILLSIDE LN
WEST LAFAYETTE IN
47906-9698
US

IV. Provider business mailing address

5317 HILLSIDE LN
WEST LAFAYETTE IN
47906-9698
US

V. Phone/Fax

Practice location:
  • Phone: 765-586-7465
  • Fax:
Mailing address:
  • Phone: 765-586-7465
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License Number28267701A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: