Provider Demographics
NPI:1033697933
Name:ROBINSON, DOMONIQUE JANAE
Entity Type:Individual
Prefix:MISS
First Name:DOMONIQUE
Middle Name:JANAE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4348 KIRBY AVE APT 2
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45223-1575
Mailing Address - Country:US
Mailing Address - Phone:937-361-3967
Mailing Address - Fax:
Practice Address - Street 1:4348 KIRBY AVE APT 2
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45223-1575
Practice Address - Country:US
Practice Address - Phone:937-361-3967
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-02
Last Update Date:2018-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide