MEDICARE: MRS. CHARLENE ROBINSON RN-348560

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	163W00000X	Registered Nurse	RN-348560	OH

General Provider Information

NPI Number	:	1992946867
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CHARLENE ROBINSON RN-348560

Provider Business Mailing Address
First Line	:	4117 E 74TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-5003
Country	:	US
Telephone Number	:	216-429-2564
Fax Number	:	216-429-2564

Provider Business Practice Location Address
First Line	:	4117 E 74TH ST
Second Line	:
City	:	CLEVELAND
State	:	OH
Zip	:	44105-5003
Country	:	US
Telephone Number	:	216-429-2564
Fax Number	:	216-429-2564

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

Provider Enumeration Date	:	03/23/2009
Last Update Date	:	03/23/2009

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