Bacon, Robyn
Bacon, Robyn is an individual health care provider with primary practice located at 10 Davol Sq Suite 400, Providence RI 02903-4754. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Bacon, Robyn can be contacted via phone (401) 421-4000.Contact Information
Primary practice address
10 Davol Sq Suite 400
Providence RI 02903-4754
Phone: (401) 421-4000
Fax: (401) 272-1456
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA00341 | Rhode Island |
Profile Details
| NPI number | 1891782579 |
|---|---|
| LBN Legal business name | Bacon, Robyn |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 29th, 2005 |
| Last updated | Jul 8th, 2007 - about 19 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1891782579 | NPPES |
| Rhode Island | Other | 27960-0 | BCBS OF RI |
| Rhode Island | Other | 411838 | BCBS OF RI |
| Rhode Island | MEDICAID | 9003736 | BCBS OF RI |
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