Provider Demographics
NPI:1295365708
Name:TUMLINSON, ROBIN GRACE
Entity Type:Individual
Prefix:
First Name:ROBIN
Middle Name:GRACE
Last Name:TUMLINSON
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 1:1104 BLACKBRIAR CIR NE
Mailing Address - Street 2:
Mailing Address - City:HARTSELLE
Mailing Address - State:AL
Mailing Address - Zip Code:35640-6206
Mailing Address - Country:US
Mailing Address - Phone:256-612-3595
Mailing Address - Fax:
Practice Address - Street 1:1104 BLACKBRIAR CIR NE
Practice Address - Street 2:
Practice Address - City:HARTSELLE
Practice Address - State:AL
Practice Address - Zip Code:35640-6206
Practice Address - Country:US
Practice Address - Phone:256-612-3595
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-23
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS12698390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program