1275515660 NPI number — MRS. ROBINETTE LOUISE JANKIEWICZ CRNA

Table of content: MRS. ROBINETTE LOUISE JANKIEWICZ CRNA (NPI 1275515660)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1275515660 NPI number — MRS. ROBINETTE LOUISE JANKIEWICZ CRNA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JANKIEWICZ
Provider First Name:
ROBINETTE
Provider Middle Name:
LOUISE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
CRNA
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TYLER
Provider Other First Name:
ROBINETTE
Provider Other Middle Name:
LOUISE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
CRNA
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1275515660
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/26/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1101 26TH STREET S.
Provider Second Line Business Mailing Address:
BENEFIS
Provider Business Mailing Address City Name:
GREAT FALLS
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59404
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-731-8755
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1101 26TH ST. S.
Provider Second Line Business Practice Location Address:
BENEFIS
Provider Business Practice Location Address City Name:
GREAT FALLS
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59405
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
406-731-8755
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
11/19/2005

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 367500000X , with the licence number:  2879 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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