MEDICARE: ROBIN KATHLEEN ROSIPKO

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	APRN.CNP.17533	OH

General Provider Information

NPI Number	:	1194105783
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN KATHLEEN ROSIPKO

Provider Business Mailing Address
First Line	:	PO BOX 378
Second Line	:
City	:	SANDUSKY
State	:	OH
Zip	:	44871-0378
Country	:	US
Telephone Number	:	419-609-1112
Fax Number	:	419-609-1123

Provider Business Practice Location Address
First Line	:	27 ST LAWRENCE DR STE 103
Second Line	:
City	:	TIFFIN
State	:	OH
Zip	:	44883-8313
Country	:	US
Telephone Number	:	419-448-4622
Fax Number	:

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

Provider Enumeration Date	:	06/09/2015
Last Update Date	:	11/19/2025

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