Provider Demographics
NPI:1306032321
Name:ROBINSON, MARLINA DIANE (PA-C)
Entity Type:Individual
Prefix:
First Name:MARLINA
Middle Name:DIANE
Last Name:ROBINSON
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 CORONADO CENTER DR
Mailing Address - Street 2:STE 211
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89052-3992
Mailing Address - Country:US
Mailing Address - Phone:702-385-7001
Mailing Address - Fax:702-385-7002
Practice Address - Street 1:2401 W HORIZON RIDGE PKWY
Practice Address - Street 2:STE 100
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89052-2706
Practice Address - Country:US
Practice Address - Phone:702-385-7001
Practice Address - Fax:702-385-7002
Is Sole Proprietor?:No
Enumeration Date:2007-09-24
Last Update Date:2019-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVPA861363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP00794969OtherRAILROAD MEDICARE
NVDH0833OtherRAILROAD MEDICARE GROUP PTAN
NV1306032321Medicaid
NVDH0833OtherRAILROAD MEDICARE GROUP PTAN