Individual
MS. ROBIN RENAE TUDOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MMS, PA-C
Contact information
Practice address
85 E US HIGHWAY 6 STE 310, VALPARAISO, IN 46383
(219) 983-6380
(219) 983-6080
Mailing address
2022 KELLE DR, CHESTERTON, IN 46304-8708
(219) 364-3616
(219) 364-3610
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10001201A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1084333
NCCPA
IN
Enumeration date
09/18/2008
Last updated
09/18/2020
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