Provider Demographics
NPI:1730184060
Name:ROBBINS-WINTERS, LINNEA M (OD)
Entity type:Individual
Prefix:DR
First Name:LINNEA
Middle Name:M
Last Name:ROBBINS-WINTERS
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17477 GENERATIONS DRIVE
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46635
Mailing Address - Country:US
Mailing Address - Phone:574-287-0890
Mailing Address - Fax:574-287-0899
Practice Address - Street 1:17477 GENERATIONS DRIVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46635
Practice Address - Country:US
Practice Address - Phone:574-287-0890
Practice Address - Fax:574-287-0899
Is Sole Proprietor?:No
Enumeration Date:2005-06-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN18002590152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN2000247660AMedicaid
IN100092650AMedicaid
INU34052Medicare UPIN
IN2000247660AMedicaid