Basic Information
Provider Information
NPI: 1477005833
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: COMMERO
FirstName: ROBIN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 555 N DUKE ST
Address2:  
City: LANCASTER
State: PA
PostalCode: 176022250
CountryCode: US
TelephoneNumber: 7175448144
FaxNumber: 7175448140
Practice Location
Address1: 555 N DUKE ST
Address2:  
City: LANCASTER
State: PA
PostalCode: 176022250
CountryCode: US
TelephoneNumber: 7175448144
FaxNumber: 7175448140
Other Information
ProviderEnumerationDate: 11/01/2016
LastUpdateDate: 01/20/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
163W00000XRN52864LPAN Nursing Service ProvidersRegistered Nurse 
363L00000XSP017073PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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