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General NPI Number Information
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NPI Number | 1306111992
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Entity Type | Organization
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Legal Business Name | HEATHER A ROBBEN OD LLC
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Dates
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Enumeration Date | 03/14/2012
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Last Update Date | 07/09/2013
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Provider Practice Location Address
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Address Line | 308 N 6TH ST
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City | WAKEENEY
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State | KS
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Zip | 67672-1802
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Country | US
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Telephone | 785-743-5522
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 458
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City | WAKEENEY
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State | KS
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Zip | 67672-0458
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Country | US
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Telephone | 785-743-5522
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Fax |
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Authorized Official
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Title or Position | OPTOMETRIST
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Name | DR. HEATHER A ROBBEN
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Credential | OD
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Telephone | 785-259-3097
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 1751
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License Number State | KS
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