=====================================================
General NPI Number Information
=====================================================
NPI Number | 1861723959
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MRS. DONNA JANICE ROBINSON
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/29/2010
-----------------------------------------------------
Last Update Date | 01/29/2010
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | RR 3 BOX 279
-----------------------------------------------------
City | MCALESTER
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74501-9533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-424-1137
-----------------------------------------------------
Fax | 918-426-3064
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | RR 3 BOX 279
-----------------------------------------------------
City | MCALESTER
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 74501-9533
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 918-424-1137
-----------------------------------------------------
Fax | 918-426-3064
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174H00000X
-----------------------------------------------------
Taxonomy Name | Health Educator
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------