Provider Demographics
NPI:1528155702
Name:LIMMER BIBB, ROBIN E (MSS, PA-C)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:E
Last Name:LIMMER BIBB
Suffix:
Gender:F
Credentials:MSS, PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5664 E HAMPTON CIR
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85206-6742
Mailing Address - Country:US
Mailing Address - Phone:480-654-2495
Mailing Address - Fax:
Practice Address - Street 1:26224 N TATUM BLVD
Practice Address - Street 2:SUITE #15A
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85050-7500
Practice Address - Country:US
Practice Address - Phone:480-663-9632
Practice Address - Fax:480-419-6782
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1978363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZS19274Medicare UPIN