Healthcare Provider Details

I. General information

NPI: 1366148819
Provider Name (Legal Business Name): KATLYN ROBISON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KATLYN IRELAND

II. Dates (important events)

Enumeration Date: 02/06/2023
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3700 SOUTHERN BLVD
KETTERING OH
45429-1265
US

IV. Provider business mailing address

3700 SOUTHERN BLVD
KETTERING OH
45429-1265
US

V. Phone/Fax

Practice location:
  • Phone: 937-281-3800
  • Fax: 937-281-3805
Mailing address:
  • Phone: 855-500-2873
  • Fax: 937-281-3805

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0033073
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: