Provider Demographics
NPI:1861007205
Name:ROBINSON, MICHELLE M (LPN)
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:M
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:151 E PROSPECT AVE APT 3F
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-2232
Mailing Address - Country:US
Mailing Address - Phone:914-803-2227
Mailing Address - Fax:
Practice Address - Street 1:151 E PROSPECT AVE APT 3F
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-2232
Practice Address - Country:US
Practice Address - Phone:914-803-2227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-09-12
Last Update Date:2020-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY332719-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse