Healthcare Provider Details

I. General information

NPI: 1447408430
Provider Name (Legal Business Name): ROBIN MICHELLE HAVENS C.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN MICHELLE LAXTON C.N.P.

II. Dates (important events)

Enumeration Date: 09/03/2008
Last Update Date: 09/10/2020
Certification Date: 09/10/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

218 STERN DRIVE
SEAMAN OH
45679-9607
US

IV. Provider business mailing address

424 WARDS CORNER RD STE 200
LOVELAND OH
45140-6966
US

V. Phone/Fax

Practice location:
  • Phone: 937-386-1379
  • Fax: 937-386-0129
Mailing address:
  • Phone: 513-707-4041
  • Fax: 513-576-1020

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP-10189
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: