Provider Demographics
NPI:1487886750
Name:STAVER, ROBIN JO (REG NURSE)
Entity type:Individual
Prefix:MRS
First Name:ROBIN
Middle Name:JO
Last Name:STAVER
Suffix:
Gender:F
Credentials:REG NURSE
Other - Prefix:MS
Other - First Name:ROBIN
Other - Middle Name:JO
Other - Last Name:YAUNKE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1320 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:BELOIT
Mailing Address - State:WI
Mailing Address - Zip Code:53511
Mailing Address - Country:US
Mailing Address - Phone:608-299-8515
Mailing Address - Fax:
Practice Address - Street 1:1320 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:BELOIT
Practice Address - State:WI
Practice Address - Zip Code:53511
Practice Address - Country:US
Practice Address - Phone:608-299-8515
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-19
Last Update Date:2009-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI125316-030163W00000X
IL041.302905163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse