Provider Demographics
NPI:1730411224
Name:ROME, ROBIN B (NP)
Entity type:Individual
Prefix:
First Name:ROBIN
Middle Name:B
Last Name:ROME
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 MEDICAL CENTER BLVD.
Mailing Address - Street 2:PALLIATIVE CARE SERVICES
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3147
Mailing Address - Country:US
Mailing Address - Phone:504-349-6011
Mailing Address - Fax:504-349-6095
Practice Address - Street 1:1101 MEDICAL CENTER BLVD.
Practice Address - Street 2:PALLIATIVE CARE SERVICES
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3147
Practice Address - Country:US
Practice Address - Phone:504-349-6011
Practice Address - Fax:504-349-6095
Is Sole Proprietor?:No
Enumeration Date:2010-02-08
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LARN 080943363L00000X
LAAP05826363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1819417Medicaid
LA1819417Medicaid