MEDICARE: ROBIN ELIZABETH MASTERS APRN

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	363L00000X	Nurse Practitioner	3014341	KY

General Provider Information

NPI Number	:	1750914438
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBIN ELIZABETH MASTERS APRN

Provider Business Mailing Address
First Line	:	1011 HARDIN HOLLY
Second Line	:
City	:	LA GRANGE
State	:	KY
Zip	:	40031-8985
Country	:	US
Telephone Number	:	502-807-6609
Fax Number	:

Provider Business Practice Location Address
First Line	:	2011 LAKE POINT WAY STE 202
Second Line	:
City	:	LOUISVILLE
State	:	KY
Zip	:	40223-4229
Country	:	US
Telephone Number	:	502-245-0777
Fax Number	:

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

Provider Enumeration Date	:	02/20/2020
Last Update Date	:	02/20/2020

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