Provider Demographics
NPI:1164011672
Name:ROBINSON, MONISHA
Entity Type:Individual
Prefix:
First Name:MONISHA
Middle Name:
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 1:7101 CAPE HARBOR DR APT J
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:28411-6593
Mailing Address - Country:US
Mailing Address - Phone:910-386-6500
Mailing Address - Fax:
Practice Address - Street 1:7101 CAPE HARBOR DR APT J
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:NC
Practice Address - Zip Code:28411-6593
Practice Address - Country:US
Practice Address - Phone:910-386-6500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-01-11
Last Update Date:2021-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
343900000X
NC24415785343900000X
NC343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)