Basic Information
Provider Information
NPI: 1255639498
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HERB
FirstName: ROBIN
MiddleName: L
NamePrefix: MRS.
NameSuffix:  
Credential: CRNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2608 KEISER BLVD
Address2:  
City: WYOMISSING
State: PA
PostalCode: 196103333
CountryCode: US
TelephoneNumber: 6106855864
FaxNumber: 6109291528
Practice Location
Address1: 2608 KEISER BLVD
Address2:  
City: WYOMISSING
State: PA
PostalCode: 196101961
CountryCode: US
TelephoneNumber: 6106855864
FaxNumber: 6109291528
Other Information
ProviderEnumerationDate: 03/12/2011
LastUpdateDate: 07/26/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/26/2022

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363LF0000XSP011300PAY Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
363LP2300XSP011300PAN Physician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care

No ID Information.


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