Healthcare Provider Details

I. General information

NPI: 1568475861
Provider Name (Legal Business Name): SHEILA MARIE ROBINS FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2006
Last Update Date: 12/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 SOUTH OHIO STREET
HUMANSVILLE MO
65674
US

IV. Provider business mailing address

104 SOUTH OHIO STREET
HUMANSVILLE MO
65674
US

V. Phone/Fax

Practice location:
  • Phone: 417-754-2223
  • Fax: 417-754-8046
Mailing address:
  • Phone: 417-754-2223
  • Fax: 417-754-8046

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number2003003715
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: