Healthcare Provider Details

I. General information

NPI: 1831476894
Provider Name (Legal Business Name): ROBIN J HUPP RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/04/2011
Last Update Date: 11/04/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2301 NEGLEY AVE SW
CANTON OH
44706-2146
US

IV. Provider business mailing address

2301 NEGLEY AVE SW
CANTON OH
44706-2146
US

V. Phone/Fax

Practice location:
  • Phone: 330-477-9029
  • Fax:
Mailing address:
  • Phone: 330-477-9029
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WH0200X
TaxonomyHome Health Registered Nurse
License NumberRN168206
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: