Healthcare Provider Details

I. General information

NPI: 1235644717
Provider Name (Legal Business Name): RONNIE ROBBINS JR.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2017
Last Update Date: 01/08/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9891 MONTGOMERY RD
CINCINNATI OH
45242-6424
US

IV. Provider business mailing address

1516 SHADOWOOD TRL
MAINEVILLE OH
45039-5032
US

V. Phone/Fax

Practice location:
  • Phone: 513-865-5204
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License Number369273
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number369273
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: