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NPI Code Detail

MEDICARE: MS. CYNTHIA DANETTE ROBERTSON R.N.

MEDICARE: MS. CYNTHIA DANETTE ROBERTSON R.N.
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
1163WH0200XHome Health Registered Nurse138489WI

General Provider Information

NPI Number : 1982896874
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. CYNTHIA DANETTE ROBERTSON R.N.
Provider Business Mailing Address
First Line : 2850 W MILL RD
Second Line : UNIT C
City : GLENDALE
State : WI
Zip : 53209-3242
Country : US
Telephone Number : 414-352-6524
Fax Number : 414-352-6524
Provider Business Practice Location Address
First Line : 5309 W FOND DU LAC AVE
Second Line : SUITE 114
City : MILWAUKEE
State : WI
Zip : 53216-1347
Country : US
Telephone Number : 414-352-6524
Fax Number : 414-352-6524
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/14/2007
Last Update Date : 08/14/2007

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