Provider Demographics
NPI:1063304657
Name:ROBIN PARKER
Entity type:Organization
Organization Name:ROBIN PARKER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:E
Authorized Official - Last Name:PARKER
Authorized Official - Suffix:
Authorized Official - Credentials:RDN, LD
Authorized Official - Phone:812-320-4876
Mailing Address - Street 1:150 N SEMINARY ST STE 100
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD
Mailing Address - State:IN
Mailing Address - Zip Code:47424-1214
Mailing Address - Country:US
Mailing Address - Phone:812-320-4876
Mailing Address - Fax:
Practice Address - Street 1:150 N SEMINARY ST STE 100
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD
Practice Address - State:IN
Practice Address - Zip Code:47424-1214
Practice Address - Country:US
Practice Address - Phone:812-320-4876
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-07-17
Last Update Date:2025-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty