Healthcare Provider Details

I. General information

NPI: 1942638820
Provider Name (Legal Business Name): ROBIN R LUTES CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROBIN R LUTES

II. Dates (important events)

Enumeration Date: 10/31/2013
Last Update Date: 09/24/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

860 ROSTRAVER RD
ROSTRAVER TOWNSHIP PA
15012-1945
US

IV. Provider business mailing address

519 GREENSBURG PIKE
WEST NEWTON PA
15089-2007
US

V. Phone/Fax

Practice location:
  • Phone: 724-929-3278
  • Fax: 724-929-3110
Mailing address:
  • Phone: 724-350-5311
  • Fax: 724-649-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number82821
License Number StateWV
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN593018
License Number StatePA
# 3
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF0813366
License Number StatePA
# 4
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP013321
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: