Healthcare Provider Details

I. General information

NPI: 1275815375
Provider Name (Legal Business Name): KRISTINE S ROBIN WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2011
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

26 QUEEN ST
WORCESTER MA
01610-2473
US

IV. Provider business mailing address

26 QUEEN ST
WORCESTER MA
01610-2473
US

V. Phone/Fax

Practice location:
  • Phone: 508-860-7700
  • Fax: 508-860-7792
Mailing address:
  • Phone: 508-860-7700
  • Fax: 508-860-7792

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License Number004724
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: