Provider Demographics
NPI:1245588912
Name:ROBINSON, FREDERIKA (FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:FREDERIKA
Middle Name:
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1051 ARLENE AVE
Mailing Address - Street 2:
Mailing Address - City:PONTIAC
Mailing Address - State:MI
Mailing Address - Zip Code:48340-2904
Mailing Address - Country:US
Mailing Address - Phone:248-451-7365
Mailing Address - Fax:
Practice Address - Street 1:1051 ARLENE AVE
Practice Address - Street 2:
Practice Address - City:PONTIAC
Practice Address - State:MI
Practice Address - Zip Code:48340-2904
Practice Address - Country:US
Practice Address - Phone:248-451-7365
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-28
Last Update Date:2014-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704217559363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily