Healthcare Provider Details

I. General information

NPI: 1619282282
Provider Name (Legal Business Name): ROBIN RENEE YANGUAS DNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN RENEE BOWLING

II. Dates (important events)

Enumeration Date: 08/08/2010
Last Update Date: 07/15/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 BRAMHALL ST
PORTLAND ME
04102-3134
US

IV. Provider business mailing address

22 BRAMHALL ST
PORTLAND ME
04102-3134
US

V. Phone/Fax

Practice location:
  • Phone: 207-662-4618
  • Fax: 207-662-6254
Mailing address:
  • Phone: 207-662-4618
  • Fax: 207-662-6254

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number3006538
License Number StateKY
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberCNP251142
License Number StateME
# 3
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberCNP251142
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: