Provider Demographics
NPI:1255677803
Name:ROBINSON, TRACEY LYNETTE (HHA)
Entity Type:Individual
Prefix:
First Name:TRACEY
Middle Name:LYNETTE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:HHA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 NAYLOR RD SE APT 310
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20020-6847
Mailing Address - Country:US
Mailing Address - Phone:202-421-2081
Mailing Address - Fax:
Practice Address - Street 1:1920 NAYLOR RD SE APT 310
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-6847
Practice Address - Country:US
Practice Address - Phone:202-421-2081
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-12-28
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC2389374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide