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General NPI Number Information
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NPI Number | 1255216115
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Entity Type | Individual
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Provider Name | ROBIN MACKENZIE GRAUMENZ RN, BSN, IBCLC
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Gender | Female
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Dates
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Enumeration Date | 08/09/2025
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Last Update Date | 08/09/2025
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Provider Practice Location Address
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Address Line | 19188 PEMBROOK
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City | MARTHASVILLE
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State | MO
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Zip | 63357-2647
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Country | US
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Telephone | 618-267-5898
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Fax | 618-267-5898
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Provider Business Mailing Address
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Address Line | 19188 PEMBROOK
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City | MARTHASVILLE
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State | MO
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Zip | 63357-2647
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Country | US
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Telephone | 618-267-5898
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Fax | 618-267-5898
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163WL0100X
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Taxonomy Name | Lactation Consultant (Registered Nurse)
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License Number | 2012036896
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License Number State | MO
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