Healthcare Provider Details

I. General information

NPI: 1275515660
Provider Name (Legal Business Name): ROBINETTE LOUISE JANKIEWICZ CRNA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ROBINETTE LOUISE TYLER CRNA

II. Dates (important events)

Enumeration Date: 11/19/2005
Last Update Date: 05/26/2021
Certification Date: 05/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 26TH ST. S. BENEFIS
GREAT FALLS MT
59405
US

IV. Provider business mailing address

1101 26TH STREET S. BENEFIS
GREAT FALLS MT
59404
US

V. Phone/Fax

Practice location:
  • Phone: 406-731-8755
  • Fax:
Mailing address:
  • Phone: 406-731-8755
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number2879
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: