Healthcare Provider Details

I. General information

NPI: 1114655230
Provider Name (Legal Business Name): ROBBYN PORTER CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBBYN ARLENE FROCK

II. Dates (important events)

Enumeration Date: 08/09/2022
Last Update Date: 06/25/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CORPORATE CENTER DR STE 100
CAMP HILL PA
17011-1758
US

IV. Provider business mailing address

100 CORPORATE CENTER DR STE 100
CAMP HILL PA
17011-1758
US

V. Phone/Fax

Practice location:
  • Phone: 717-763-1174
  • Fax: 717-763-8960
Mailing address:
  • Phone: 717-763-1174
  • Fax: 717-763-8960

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberSP025872
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberSP025872
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberSP025872
License Number StatePA
# 4
Primary TaxonomyN
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberRN325024L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: