Provider Demographics
NPI:1043689664
Name:ROBINSON, MICHELLE (NP-C)
Entity Type:Individual
Prefix:
First Name:MICHELLE
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1018 JUDIE DR
Mailing Address - Street 2:
Mailing Address - City:SANDWICH
Mailing Address - State:IL
Mailing Address - Zip Code:60548-9205
Mailing Address - Country:US
Mailing Address - Phone:815-342-3613
Mailing Address - Fax:
Practice Address - Street 1:2365 SPRINGS RD NE
Practice Address - Street 2:
Practice Address - City:HICKORY
Practice Address - State:NC
Practice Address - Zip Code:28601-3067
Practice Address - Country:US
Practice Address - Phone:828-325-0950
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-24
Last Update Date:2015-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC5008032363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner