Healthcare Provider Details

I. General information

NPI: 1306335955
Provider Name (Legal Business Name): LAUREN KAY ROBINSON NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/08/2018
Last Update Date: 01/06/2024
Certification Date: 01/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

423 FORTRESS BLVD
MORGANTOWN WV
26508-1351
US

IV. Provider business mailing address

423 FORTRESS BLVD
MORGANTOWN WV
26508-1351
US

V. Phone/Fax

Practice location:
  • Phone: 844-852-9510
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number28209611A
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number71007996A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: