MEDICARE: ROBYN EWING FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	10000919	OR

General Provider Information

NPI Number	:	1093422321
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBYN EWING FNP

Provider Business Mailing Address
First Line	:	5542 MASON LN
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-9378
Country	:	US
Telephone Number	:	541-205-8586
Fax Number	:

Provider Business Practice Location Address
First Line	:	2617 ALMOND ST
Second Line	:
City	:	KLAMATH FALLS
State	:	OR
Zip	:	97601-1116
Country	:	US
Telephone Number	:	541-274-8900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/07/2022
Last Update Date	:	01/12/2023

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