Provider Demographics
NPI:1144254582
Name:ROBINE, VIRGINIA ANN (DO)
Entity type:Individual
Prefix:
First Name:VIRGINIA
Middle Name:ANN
Last Name:ROBINE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6355 S BUFFALO DR FL 3
Mailing Address - Street 2:
Mailing Address - City:LAS VEGAS
Mailing Address - State:NV
Mailing Address - Zip Code:89113-2133
Mailing Address - Country:US
Mailing Address - Phone:702-216-3346
Mailing Address - Fax:702-671-6883
Practice Address - Street 1:6380 N DECATUR BLVD STE 215
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89130-8004
Practice Address - Country:US
Practice Address - Phone:702-948-1145
Practice Address - Fax:702-949-6206
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-10
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MOR7N57207Q00000X
NVDO2754207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MOR7N57OtherSTATE LICENSE
NV1144254582Medicaid
NVDO2754OtherSTATE LICENSE